| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Administration Deficiencies |
02/19/2004 |
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 |
02/19/2004 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
02/19/2004 |
Have a program to keep infection from spreading. |
Isolated |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
02/19/2004 |
1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
02/19/2004 |
Hire a qualified dietician. |
Widespread |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
02/19/2004 |
Make sure that residents are well nourished. |
Widespread |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
02/19/2004 |
Make sure that the attending doctor orders special diets. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
02/19/2004 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
02/19/2004 |
Provide activities to meet the needs of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
02/19/2004 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
02/19/2004 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
02/19/2004 |
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 |
| Quality Care Deficiencies |
02/19/2004 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
02/19/2004 |
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 |
02/19/2004 |
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 |
02/19/2004 |
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 Rights Deficiencies |
02/19/2004 |
Keep each resident's personal and medical records private and confidential. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
02/19/2004 |
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 |
02/19/2004 |
Listen to the resident or family groups or act on their complaints or suggestions. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/27/2005 |
Provide needed housekeeping and maintenance. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/27/2005 |
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 |
01/27/2005 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/27/2005 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/27/2005 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
01/27/2005 |
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 |
01/27/2005 |
Properly hold, secure and manage each resident's personal money which is deposited with the nursing home. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
01/27/2005 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Pattern |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
04/07/2006 |
Keep accurate and appropriate medical records. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
04/07/2006 |
Provide needed housekeeping and maintenance. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
04/07/2006 |
Have a program to keep infection from spreading. |
Isolated |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
04/07/2006 |
1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
04/07/2006 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
04/07/2006 |
1) Make sure that residents who take drugs are not given too many doses or for too long; 2) make sure that the use of drugs is carefully watched; or 3) stop or change drugs that cause unwanted effects. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
04/07/2006 |
Provide drugs and related services needed by each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
04/07/2006 |
Make sure that the pharmacist reports anything unusual to the doctor on duty and the director of nursing. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
04/07/2006 |
Act when the pharmacist reports something unusual. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
04/07/2006 |
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 |
| Quality Care Deficiencies |
04/07/2006 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
04/07/2006 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
04/07/2006 |
Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
04/07/2006 |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Building Contruction Deficiencies |
02/17/2004 |
a two-hour-resistant firewall in common walls. |
Widespread |
Minimal harm or potential for actual harm |
| Building Service Equipment Deficiencies |
02/17/2004 |
an externally vented heating system. |
Widespread |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
02/17/2004 |
weekly inspections and monthly testing of generators. |
Isolated |
Minimal harm or potential for actual harm |
| Emergency Plans and Fire Drills Deficiencies |
02/17/2004 |
did not have a written emergency evacuation plan. |
Widespread |
Minimal harm or potential for actual harm |
| Emergency Plans and Fire Drills Deficiencies |
02/17/2004 |
record of quarterly fire drills for each shift under varying conditions. |
Widespread |
Minimal harm or potential for actual harm |
| Exits and Egress Deficiencies |
02/17/2004 |
exits that are accessible at all times. |
Widespread |
Minimal harm or potential for actual harm |
| Hazardous Area Deficiencies |
02/17/2004 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Widespread |
Minimal harm or potential for actual harm |
| Illumination and Emergency Power Deficiencies |
02/17/2004 |
emergency lighting that can last at least 1 1/2 hours. |
Isolated |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
02/17/2004 |
at least two compartments on every floor to protect residents from smoke. |
Widespread |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
02/17/2004 |
smoke barrier doors that can resist smoke for at least 20 minutes. |
Widespread |
Minimal harm or potential for actual harm |