| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Environmental Deficiencies |
12/19/2003 |
Keep safe, clean and homelike surroundings. |
Widespread |
Potential for minimal harm |
| Environmental Deficiencies |
12/19/2003 |
Make sure that staff members wash their hands when needed. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/19/2003 |
Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection. |
Widespread |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/19/2003 |
Provide at least one room to use as a dining room and for activities, that is a good size, with good lighting, airflow and furniture. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
12/19/2003 |
Hire enough skilled workers to carry out dietary service. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
12/19/2003 |
Make sure that residents are well nourished. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
12/19/2003 |
Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
12/19/2003 |
Provide food in a way that meets a resident's needs. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
12/19/2003 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
12/19/2003 |
Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/19/2003 |
Provide social services for related medical problems to help each resident achieve the highest possible quality of life. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/19/2003 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/19/2003 |
Make sure that each resident who enters the nursing home without a catheter is not given a catheter, unless it is necessary. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
12/19/2003 |
Make a complete assessment that covers all questions for areas that are listed in official regulations. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
12/19/2003 |
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
12/19/2003 |
1) Develop a complete care plan within 7 days of each resident's admission; 2) prepare a care plan with the care team, including the primary nurse, doctor, resident or resident's family or representative; or 3) check and update the care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
12/19/2003 |
Honor all of the resident's rights as a resident of the nursing home and as a citizen or resident of the United States. |
Widespread |
Potential for minimal harm |
| Resident Rights Deficiencies |
12/19/2003 |
Tell each resident who can get Medicaid benefits about 1) which items and services Medicaid covers and which the resident must pay for; or 2) how to apply for Medicaid, along with the names and addresses of State groups that can help. |
Widespread |
Potential for minimal harm |
| Resident Rights Deficiencies |
12/19/2003 |
Provide proof that all residents' personal money which is deposited with the nursing home, is secure. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
12/19/2003 |
Keep each resident's personal and medical records private and confidential. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
12/19/2003 |
Let residents complain without being treated differently or badly. |
Pattern |
Potential for minimal harm |
| Resident Rights Deficiencies |
12/19/2003 |
Provide services to meet the needs and preferences of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/16/2004 |
Have a program to keep infection from spreading. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/16/2004 |
Make sure that staff members wash their hands when needed. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/16/2004 |
Make sure that a working call system is available in each resident's room or bathroom and bathing area. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
12/16/2004 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Potential for minimal harm |
| Quality Care Deficiencies |
12/16/2004 |
Give each resident care and services to get or keep the highest quality of life possible. |
Isolated |
Actual harm |
| Quality Care Deficiencies |
12/16/2004 |
Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/16/2004 |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Isolated |
Actual harm |
| Quality Care Deficiencies |
12/16/2004 |
Give proper treatment to residents with feeding tubes to prevent problems (such as aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, nasal-pharyngeal ulcers) and help restore eating skills, if possible. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
12/16/2004 |
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
02/24/2006 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
02/24/2006 |
Provide social services for related medical problems to help each resident achieve the highest possible quality of life. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
02/24/2006 |
1) Develop a complete care plan within 7 days of each resident's admission; 2) prepare a care plan with the care team, including the primary nurse, doctor, resident or resident's family or representative; or 3) check and update the care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
02/24/2006 |
Properly hold, secure and manage each resident's personal money which is deposited with the nursing home. |
Pattern |
Potential for minimal harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Corridor Walls and Doors Deficiencies |
12/31/2003 |
corridor and hallway doors that block smoke. |
Pattern |
Potential for minimal harm |
| Automatic Sprinkler Systems Deficiencies |
12/20/2004 |
an approved automatic sprinkler system connected to the fire alarm system. |
Isolated |
Minimal harm or potential for actual harm |
| Building Service Equipment Deficiencies |
12/20/2004 |
an externally vented heating system. |
Isolated |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
12/20/2004 |
the appropriate emergency electrical equipment. |
Isolated |
Minimal harm or potential for actual harm |