| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Environmental Deficiencies |
05/14/2004 |
Provide needed housekeeping and maintenance. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
05/14/2004 |
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 |
05/14/2004 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
05/14/2004 |
Act when the pharmacist reports something unusual. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/14/2004 |
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 |
05/14/2004 |
Give professional services that meet a professional standard of quality. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/14/2004 |
Give each resident care and services to get or keep the highest quality of life possible. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/14/2004 |
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 |
| Resident Assessment Deficiencies |
05/14/2004 |
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 |
05/14/2004 |
Properly hold, secure and manage each resident's personal money which is deposited with the nursing home. |
Widespread |
Potential for minimal harm |
| Resident Rights Deficiencies |
05/14/2004 |
Quickly give a resident's personal money to the heads of his or her estate after the resident's death. |
Pattern |
Potential for minimal harm |
| Resident Rights Deficiencies |
05/14/2004 |
Keep each resident's personal and medical records private and confidential. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
05/14/2004 |
Try to resolve each resident's complaints quickly. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
05/14/2004 |
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 |
04/21/2005 |
Keep safe, clean and homelike surroundings. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
04/21/2005 |
Provide needed housekeeping and maintenance. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
04/21/2005 |
Keep sound levels comfortable. |
Widespread |
Potential for minimal harm |
| Environmental Deficiencies |
04/21/2005 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Pattern |
Potential for minimal harm |
| Environmental Deficiencies |
04/21/2005 |
Get rid of garbage properly. |
Widespread |
Potential for minimal harm |
| Environmental Deficiencies |
04/21/2005 |
Provide bedrooms that don't allow residents to see each other when privacy is needed. |
Pattern |
Potential for minimal harm |
| Mistreatment Deficiencies |
04/21/2005 |
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 |
| Pharmacy Service Deficiencies |
04/21/2005 |
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 |
| Quality Care Deficiencies |
04/21/2005 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
04/21/2005 |
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. |
Pattern |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
06/28/2006 |
Keep accurate and appropriate medical records. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
06/28/2006 |
Provide needed housekeeping and maintenance. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
06/28/2006 |
Keep sound levels comfortable. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
06/28/2006 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
06/28/2006 |
Get rid of garbage properly. |
Widespread |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
06/28/2006 |
Have a program to keep infection from spreading. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
06/28/2006 |
Provide bedrooms that don't allow residents to see each other when privacy is needed. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
06/28/2006 |
Make sure that a working call system is available in each resident's room or bathroom and bathing area. |
Pattern |
Potential for minimal harm |
| Mistreatment Deficiencies |
06/28/2006 |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Isolated |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
06/28/2006 |
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 |
Actual harm |
| Nutrition and Dietary Deficiencies |
06/28/2006 |
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 |
06/28/2006 |
1) Provide 3 meals daily at regular times; or 2) serve breakfast within 14 hours after dinner; or 3) offer a snack at bedtime each day. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
06/28/2006 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
06/28/2006 |
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 |
Actual harm |
| Pharmacy Service Deficiencies |
06/28/2006 |
Properly mark drugs and other similar products. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
06/28/2006 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
06/28/2006 |
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 |
06/28/2006 |
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 |
06/28/2006 |
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 Assessment Deficiencies |
06/28/2006 |
Provide a final summary of the resident's health status and a summary of the resident's stay, when the resident is ready to leave the nursing home. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
06/28/2006 |
Quickly give a resident's personal money to the heads of his or her estate after the resident's death. |
Widespread |
Potential for minimal harm |
| Resident Rights Deficiencies |
06/28/2006 |
Try to resolve each resident's complaints quickly. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
06/28/2006 |
Send and promptly deliver unopened mail to residents. |
Widespread |
Potential for minimal harm |
| Resident Rights Deficiencies |
06/28/2006 |
Protect the resident from a transfer or discharge that is not wanted or needed. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
06/28/2006 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Pattern |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Automatic Sprinkler Systems Deficiencies |
04/19/2005 |
an approved automatic sprinkler system connected to the fire alarm system. |
Widespread |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
04/19/2005 |
corridors that are separated from common areas by walls constructed to limit the passage of smoke. |
Widespread |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
04/19/2005 |
corridor and hallway doors that block smoke. |
Widespread |
Minimal harm or potential for actual harm |
| Emergency Plans and Fire Drills Deficiencies |
04/19/2005 |
record of quarterly fire drills for each shift under varying conditions. |
Widespread |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
04/19/2005 |
properly sized and located compartments to protect residents from smoke. |
Widespread |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
06/26/2006 |
automatic sprinkler systems that have been maintained in working order. |
Widespread |
Minimal harm or potential for actual harm |
| Building Service Equipment Deficiencies |
06/26/2006 |
heating and ventilation systems that have been properly installed according to the manufacturer's instructions. |
Widespread |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
06/26/2006 |
weekly inspections and monthly testing of generators. |
Widespread |
Minimal harm or potential for actual harm |
| Emergency Plans and Fire Drills Deficiencies |
06/26/2006 |
record of quarterly fire drills for each shift under varying conditions. |
Widespread |
Minimal harm or potential for actual harm |