| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Quality Care Deficiencies |
11/06/2003 |
Give professional services that follow each resident's written care plan. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
11/06/2003 |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
11/06/2003 |
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
11/06/2003 |
Let residents give themselves their drugs if they are able. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
12/31/2004 |
Be administered in a way that leads to the highest possible level of well being for each resident. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/31/2004 |
Keep safe, clean and homelike surroundings. |
Isolated |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
12/31/2004 |
Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/31/2004 |
Give each resident care and services to get or keep the highest quality of life possible. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/31/2004 |
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 |
12/31/2004 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Immediate jeopardy to resident health or safety |
| Resident Assessment Deficiencies |
12/31/2004 |
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
12/31/2004 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
01/12/2006 |
Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/12/2006 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/12/2006 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/12/2006 |
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 |
01/12/2006 |
Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
01/12/2006 |
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 Assessment Deficiencies |
01/12/2006 |
Keep assessments completed in the preceding 15 months in the resident's active record. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
01/12/2006 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Automatic Sprinkler Systems Deficiencies |
11/13/2003 |
automatic sprinkler systems that have been maintained in working order. |
Pattern |
Potential for minimal harm |
| Automatic Sprinkler Systems Deficiencies |
01/03/2005 |
automatic sprinkler systems that have been maintained in working order. |
Pattern |
Minimal harm or potential for actual harm |
| Building Service Equipment Deficiencies |
01/03/2005 |
properly protected cooking facilities. |
Pattern |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
01/03/2005 |
corridor and hallway doors that block smoke. |
Pattern |
Minimal harm or potential for actual harm |
| Emergency Plans and Fire Drills Deficiencies |
01/03/2005 |
record of quarterly fire drills for each shift under varying conditions. |
Pattern |
Potential for minimal harm |
| Exits and Egress Deficiencies |
01/03/2005 |
exits that are accessible at all times. |
Pattern |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
01/03/2005 |
an approved installation, maintenance and testing program for fire alarm systems. |
Pattern |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
01/03/2005 |
properly maintained smoke detectors. |
Pattern |
Minimal harm or potential for actual harm |
| Hazardous Area Deficiencies |
01/03/2005 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Pattern |
Minimal harm or potential for actual harm |
| Illumination and Emergency Power Deficiencies |
01/03/2005 |
proper backup exit lighting. |
Isolated |
Minimal harm or potential for actual harm |
| Medical Gases and Anesthetizing Areas Deficiencies |
01/03/2005 |
proper medical gas storage and administration areas. |
Pattern |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
01/03/2005 |
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 |
| Smoke Compartmentation and Control Deficiencies |
01/03/2005 |
smoke barrier doors that can resist smoke for at least 20 minutes. |
Pattern |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
01/03/2005 |
proper construction of ducts through walls designed to prevent smoke passage. |
Isolated |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
01/26/2006 |
an approved automatic sprinkler system connected to the fire alarm system. |
Isolated |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
01/26/2006 |
corridor and hallway doors that block smoke. |
Isolated |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
01/26/2006 |
properly installed electrical wiring and equipment. |
Pattern |
Minimal harm or potential for actual harm |
| Exits and Egress Deficiencies |
01/26/2006 |
exits that are accessible at all times. |
Widespread |
Potential for minimal harm |
| Fire Alarm Systems Deficiencies |
01/26/2006 |
an approved installation, maintenance and testing program for fire alarm systems. |
Pattern |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
01/26/2006 |
properly maintained smoke detectors. |
Pattern |
Minimal harm or potential for actual harm |
| Hazardous Area Deficiencies |
01/26/2006 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Pattern |
Minimal harm or potential for actual harm |
| Illumination and Emergency Power Deficiencies |
01/26/2006 |
emergency lighting that can last at least 1 1/2 hours. |
Pattern |
Minimal harm or potential for actual harm |
| Smoking Regulations Deficiencies |
01/26/2006 |
posted No-smoking signs in areas where smoking is not permitted or did not provide ashtrays where smoking was allowed. |
Isolated |
Minimal harm or potential for actual harm |