| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Administration Deficiencies |
05/13/2004 |
Get services outside the nursing home that meet professional standards. |
Widespread |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
05/13/2004 |
Quickly tell the resident's doctor the results of lab tests. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
05/13/2004 |
Provide needed housekeeping and maintenance. |
Pattern |
Potential for minimal harm |
| Environmental Deficiencies |
05/13/2004 |
Have a program to keep infection from spreading. |
Isolated |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
05/13/2004 |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
05/13/2004 |
Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%. |
Pattern |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
05/13/2004 |
Make sure that residents are safe from serious medication errors. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
05/13/2004 |
Act when the pharmacist reports something unusual. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/13/2004 |
Give professional services that meet a professional standard of quality. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/13/2004 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/13/2004 |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/13/2004 |
Make sure that each resident's nutritional needs were met. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
05/13/2004 |
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 Assessment Deficiencies |
05/13/2004 |
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 |
05/13/2004 |
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 |
| Resident Assessment Deficiencies |
05/13/2004 |
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 |
05/13/2004 |
Keep assessments completed in the preceding 15 months in the resident's active record. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
05/13/2004 |
Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
05/13/2004 |
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 |
05/13/2004 |
Keep each resident's personal and medical records private and confidential. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
05/13/2004 |
Listen to the resident or family groups or act on their complaints or suggestions. |
Widespread |
Potential for minimal harm |
| Administration Deficiencies |
03/10/2005 |
Set up or keep a group of people to review and ensure quality. |
Widespread |
Potential for minimal harm |
| Environmental Deficiencies |
03/10/2005 |
Have a program to keep infection from spreading. |
Widespread |
Potential for minimal harm |
| Mistreatment Deficiencies |
03/10/2005 |
Protect residents from mistreatment, neglect, and/or theft of personal property. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
03/10/2005 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
03/10/2005 |
Make sure that each residents' abilities to take care of themselves does not lessen, unless a change cannot be avoided. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
03/10/2005 |
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 Rights Deficiencies |
03/10/2005 |
Properly hold, secure and manage each resident's personal money which is deposited with the nursing home. |
Widespread |
Potential for minimal harm |
| Environmental Deficiencies |
05/03/2006 |
Provide needed housekeeping and maintenance. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
05/03/2006 |
Make sure that the nursing home area is safe, easy to use, clean and comfortable. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
05/03/2006 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/03/2006 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
05/03/2006 |
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 |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Miscellaneous Deficiencies |
05/10/2004 |
fire safety features required by current fire safety codes. |
Widespread |
Minimal harm or potential for actual harm |
| Emergency Plans and Fire Drills Deficiencies |
05/03/2006 |
did not have a written emergency evacuation plan. |
Widespread |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
05/03/2006 |
an automatic smoke detection system in all hallways. |
Widespread |
Minimal harm or potential for actual harm |