| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Environmental Deficiencies |
12/10/2003 |
Provide needed housekeeping and maintenance. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
12/10/2003 |
Make sure that the attending doctor orders special diets. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
12/10/2003 |
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 |
12/10/2003 |
Make sure that residents who have not taken antipsychotic drugs are not given these drugs, unless they are used to treat a problem that is diagnosed and noted in the medical record. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
12/10/2003 |
Act when the pharmacist reports something unusual. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/10/2003 |
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 |
12/10/2003 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
12/10/2003 |
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 |
11/10/2004 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
11/10/2004 |
Make sure that the attending doctor orders special diets. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
11/10/2004 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
11/10/2004 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
11/10/2004 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
11/10/2004 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/26/2006 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/26/2006 |
Get rid of garbage properly. |
Widespread |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/26/2006 |
Have a program to keep infection from spreading. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/26/2006 |
Make sure that staff members wash their hands when needed. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/26/2006 |
Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection. |
Widespread |
Potential for minimal harm |
| Mistreatment Deficiencies |
01/26/2006 |
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. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/26/2006 |
Hire a qualified dietician. |
Widespread |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/26/2006 |
Make sure that residents are well nourished. |
Widespread |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/26/2006 |
Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. |
Widespread |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/26/2006 |
Provide food in a way that meets a resident's needs. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/26/2006 |
Make sure that the attending doctor orders special diets. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/26/2006 |
Provide special eating equipment and utensils for each resident who needs them. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/26/2006 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
01/26/2006 |
Provide drugs and related services needed by each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/26/2006 |
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 |
01/26/2006 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/26/2006 |
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 |
01/26/2006 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Actual harm |
| Quality Care Deficiencies |
01/26/2006 |
Make sure that each resident's nutritional needs were met. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
01/26/2006 |
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 Rights Deficiencies |
01/26/2006 |
Honor all of the resident's rights as a resident of the nursing home and as a citizen or resident of the United States. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
01/26/2006 |
Bill properly: Charged resident for items that Medicare or Medicaid pays for. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
01/26/2006 |
Have a private telephone available for use. |
Pattern |
Potential for minimal harm |
| Resident Rights Deficiencies |
01/26/2006 |
Let residents give themselves their drugs if they are able. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Building Service Equipment Deficiencies |
12/08/2003 |
heating and ventilation systems that have been properly installed according to the manufacturer's instructions. |
Widespread |
Minimal harm or potential for actual harm |
| Building Service Equipment Deficiencies |
12/08/2003 |
properly protected cooking facilities. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
12/08/2003 |
an approved installation, maintenance and testing program for fire alarm systems. |
Widespread |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
12/08/2003 |
properly maintained smoke detectors. |
Widespread |
Minimal harm or potential for actual harm |
| Medical Gases and Anesthetizing Areas Deficiencies |
12/08/2003 |
proper medical gas storage and administration areas. |
Isolated |
Minimal harm or potential for actual harm |