| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Environmental Deficiencies |
09/25/2003 |
Keep safe, clean and homelike surroundings. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
09/25/2003 |
Keep adequate and comfortable lighting in all areas. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
09/25/2003 |
Make sure that staff members wash their hands when needed. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
09/25/2003 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
09/25/2003 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
09/25/2003 |
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 |
09/25/2003 |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Isolated |
Actual harm |
| Resident Assessment Deficiencies |
09/25/2003 |
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 |
09/25/2003 |
Provide services to meet the needs and preferences of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
10/01/2004 |
Hire a qualified activities director. |
Widespread |
Potential for minimal harm |
| Administration Deficiencies |
10/01/2004 |
Hire a qualified social worker; or in homes with more than 120 beds, hire a qualified full-time social worker. |
Widespread |
Potential for minimal harm |
| Administration Deficiencies |
10/01/2004 |
Get services outside the nursing home that meet professional standards. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
10/01/2004 |
Keep accurate and appropriate medical records. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
10/01/2004 |
Provide needed housekeeping and maintenance. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
10/01/2004 |
Have a program to keep infection from spreading. |
Widespread |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
10/01/2004 |
Make sure that staff members wash their hands when needed. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
10/01/2004 |
Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection. |
Pattern |
Potential for minimal harm |
| Nutrition and Dietary Deficiencies |
10/01/2004 |
Make sure that the attending doctor orders special diets. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
10/01/2004 |
1) Provide 3 meals daily at regular times; or 2) serve breakfast within 14 hours after dinner; or 3) offer a snack at bedtime each day. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
10/01/2004 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
10/01/2004 |
Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
10/01/2004 |
Properly mark drugs and other similar products. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
10/01/2004 |
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 |
10/01/2004 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
10/01/2004 |
Give professional services that follow each resident's written care plan. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
10/01/2004 |
Give each resident care and services to get or keep the highest quality of life possible. |
Isolated |
Actual harm |
| Quality Care Deficiencies |
10/01/2004 |
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 |
10/01/2004 |
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 |
| Quality Care Deficiencies |
10/01/2004 |
Give each resident enough fluids to keep them healthy and prevent dehydration. |
Isolated |
Actual harm |
| Resident Assessment Deficiencies |
10/01/2004 |
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 Rights Deficiencies |
10/01/2004 |
Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
10/01/2004 |
Properly hold, secure and manage each resident's personal money which is deposited with the nursing home. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
10/01/2004 |
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 |
10/01/2004 |
Try to resolve each resident's complaints quickly. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
10/01/2004 |
Let residents give themselves their drugs if they are able. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
10/01/2004 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
10/01/2004 |
Provide services to meet the needs and preferences of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/23/2006 |
Provide needed housekeeping and maintenance. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/23/2006 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/23/2006 |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Isolated |
Actual harm |
| Quality Care Deficiencies |
01/23/2006 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Building Service Equipment Deficiencies |
10/03/2003 |
properly protected cooking facilities. |
Pattern |
Potential for minimal harm |
| Hazardous Area Deficiencies |
10/03/2003 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Pattern |
Potential for minimal harm |
| Miscellaneous Deficiencies |
10/03/2003 |
fire safety features required by current fire safety codes. |
Pattern |
Potential for minimal harm |
| Automatic Sprinkler Systems Deficiencies |
09/28/2004 |
portable fire extinguishers. |
Widespread |
Potential for minimal harm |
| Corridor Walls and Doors Deficiencies |
09/28/2004 |
corridor and hallway doors that block smoke. |
Pattern |
Potential for minimal harm |
| Electrical Deficiencies |
09/28/2004 |
properly installed electrical wiring and equipment. |
Isolated |
Minimal harm or potential for actual harm |
| Exits and Egress Deficiencies |
09/28/2004 |
exits that are accessible at all times. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
09/28/2004 |
properly maintained smoke detectors. |
Isolated |
Minimal harm or potential for actual harm |
| Hazardous Area Deficiencies |
09/28/2004 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Isolated |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
02/01/2006 |
an approved automatic sprinkler system connected to the fire alarm system. |
Isolated |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
02/01/2006 |
properly installed electrical wiring and equipment. |
Isolated |
Minimal harm or potential for actual harm |
| Emergency Plans and Fire Drills Deficiencies |
02/01/2006 |
record of quarterly fire drills for each shift under varying conditions. |
Isolated |
Minimal harm or potential for actual harm |
| Exits and Egress Deficiencies |
02/01/2006 |
exits that are accessible at all times. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
02/01/2006 |
an approved installation, maintenance and testing program for fire alarm systems. |
Isolated |
Minimal harm or potential for actual harm |
| Miscellaneous Deficiencies |
02/01/2006 |
fire safety features required by current fire safety codes. |
Isolated |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
02/01/2006 |
walls or barriers that prevent smoke from passing through and would resist fire for at least one hour. |
Pattern |
Minimal harm or potential for actual harm |