| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Environmental Deficiencies |
09/25/2003 |
Make sure that staff members wash their hands when needed. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
09/25/2003 |
Make sure that the nursing home area is safe, easy to use, clean and comfortable. |
Pattern |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
09/25/2003 |
Properly mark drugs and other similar products. |
Pattern |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
09/25/2003 |
Keep drugs and other similar products locked safely and properly stored. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
09/25/2003 |
Provide activities to meet the needs of each resident. |
Isolated |
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 with reduced range of motion get proper treatment and services to increase range of motion. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
09/25/2003 |
Try to resolve each resident's complaints quickly. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
09/25/2003 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
10/28/2004 |
Keep safe, clean and homelike surroundings. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
10/28/2004 |
Make sure that staff members wash their hands when needed. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
10/28/2004 |
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 |
10/28/2004 |
Hire enough skilled workers to carry out dietary service. |
Widespread |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
10/28/2004 |
Provide special eating equipment and utensils for each resident who needs them. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
10/28/2004 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
10/28/2004 |
Keep drugs and other similar products locked safely and properly stored. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
10/28/2004 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
10/28/2004 |
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 |
10/28/2004 |
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 |
10/28/2004 |
Provide proof that all residents' personal money which is deposited with the nursing home, is secure. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
10/28/2004 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
10/28/2004 |
Make sure each resident has the right to choose activities, schedules and health care according to his or her interests, assessment, and plan of care. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
12/07/2005 |
1) Review the work of each nurse aide every year; or 2) give regular training for the nurse aides. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
12/07/2005 |
Keep accurate and appropriate medical records. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/07/2005 |
Provide needed housekeeping and maintenance. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/07/2005 |
Keep sound levels comfortable. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/07/2005 |
Have a program to keep infection from spreading. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/07/2005 |
Make sure that staff members wash their hands when needed. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/07/2005 |
Provide bedrooms that don't allow residents to see each other when privacy is needed. |
Isolated |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
12/07/2005 |
Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property. |
Pattern |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
12/07/2005 |
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 |
12/07/2005 |
Make sure that residents are safe from serious medication errors. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/07/2005 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/07/2005 |
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 |
12/07/2005 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/07/2005 |
Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
12/07/2005 |
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 |
12/07/2005 |
Provide proof that all residents' personal money which is deposited with the nursing home, is secure. |
Widespread |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
12/07/2005 |
Listen to the resident or family groups or act on their complaints or suggestions. |
Pattern |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Building Service Equipment Deficiencies |
09/25/2003 |
heating and ventilation systems that have been properly installed according to the manufacturer's instructions. |
Isolated |
Minimal harm or potential for actual harm |
| Building Service Equipment Deficiencies |
09/25/2003 |
properly protected cooking facilities. |
Isolated |
Minimal harm or potential for actual harm |
| Exits and Egress Deficiencies |
09/25/2003 |
exits that are accessible at all times. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
09/25/2003 |
an approved installation, maintenance and testing program for fire alarm systems. |
Isolated |
Minimal harm or potential for actual harm |
| Furnishings and Decorations Deficiencies |
09/25/2003 |
exits that are free from obstructions and can be used at all times. |
Isolated |
Minimal harm or potential for actual harm |
| Vertical Openings Deficiencies |
09/25/2003 |
exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detectors. |
Isolated |
Minimal harm or potential for actual harm |
| Building Service Equipment Deficiencies |
10/28/2004 |
heating and ventilation systems that have been properly installed according to the manufacturer's instructions. |
Isolated |
Minimal harm or potential for actual harm |
| Emergency Plans and Fire Drills Deficiencies |
10/28/2004 |
record of quarterly fire drills for each shift under varying conditions. |
Isolated |
Minimal harm or potential for actual harm |
| Illumination and Emergency Power Deficiencies |
10/28/2004 |
emergency lighting that can last at least 1 1/2 hours. |
Pattern |
Minimal harm or potential for actual harm |
| Miscellaneous Deficiencies |
12/05/2005 |
fire safety features required by current fire safety codes. |
Isolated |
Minimal harm or potential for actual harm |
| Vertical Openings Deficiencies |
12/05/2005 |
exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detectors. |
Isolated |
Minimal harm or potential for actual harm |