| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Administration Deficiencies |
11/20/2003 |
Give or get lab tests to meet the needs of residents. |
Isolated |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
11/20/2003 |
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 |
| Nutrition and Dietary Deficiencies |
11/20/2003 |
Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. |
Pattern |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
11/20/2003 |
Provide drugs and related services needed by each resident. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
11/20/2003 |
Use the services of a licensed pharmacist. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
11/20/2003 |
Properly mark drugs and other similar products. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
11/20/2003 |
Keep drugs and other similar products locked safely and properly stored. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
11/20/2003 |
Give each resident care and services to get or keep the highest quality of life possible. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
11/20/2003 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
12/23/2004 |
Keep accurate and appropriate medical records. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/23/2004 |
Keep safe, clean and homelike surroundings. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/23/2004 |
Provide needed housekeeping and maintenance. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/23/2004 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/23/2004 |
Have a program to keep infection from spreading. |
Pattern |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
12/23/2004 |
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 |
12/23/2004 |
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 |
12/23/2004 |
Properly mark drugs and other similar products. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
12/23/2004 |
Keep drugs and other similar products locked safely and properly stored. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/23/2004 |
Provide activities to meet the needs of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/23/2004 |
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 |
| Resident Assessment Deficiencies |
12/23/2004 |
Keep assessments completed in the preceding 15 months in the resident's active record. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
12/23/2004 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
01/06/2006 |
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 |
01/06/2006 |
Have drugs and other similar products available, which are needed every day and in emergencies, and give them out properly. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/06/2006 |
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 |
01/06/2006 |
Make sure that each resident who enters the nursing home without a catheter is not given a catheter, unless it is necessary. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
01/06/2006 |
Make a complete assessment that covers all questions for areas that are listed in official regulations. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
01/06/2006 |
Check and update (if needed) each resident's assessment every 3 months. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
01/06/2006 |
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 Rights Deficiencies |
01/06/2006 |
Tell each resident who can get Medicaid benefits about 1) which items and services Medicaid covers and which the resident must pay for; or 2) how to apply for Medicaid, along with the names and addresses of State groups that can help. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
01/06/2006 |
Try to resolve each resident's complaints quickly. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
01/06/2006 |
Send and promptly deliver unopened mail to residents. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
01/06/2006 |
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 |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Automatic Sprinkler Systems Deficiencies |
11/19/2003 |
an approved automatic sprinkler system connected to the fire alarm system. |
Isolated |
Minimal harm or potential for actual harm |
| Exits and Egress Deficiencies |
11/19/2003 |
exits that are accessible at all times. |
Isolated |
Minimal harm or potential for actual harm |
| Interior Finish Deficiencies |
11/19/2003 |
fire-resistant interior walls. |
Widespread |
Minimal harm or potential for actual harm |
| Interior Finish Deficiencies |
11/19/2003 |
fire-resistant room wall surfaces. |
Widespread |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
12/21/2004 |
an approved automatic sprinkler system connected to the fire alarm system. |
Widespread |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
12/21/2004 |
corridor and hallway doors that block smoke. |
Isolated |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
12/21/2004 |
weekly inspections and monthly testing of generators. |
Widespread |
Minimal harm or potential for actual harm |
| Furnishings and Decorations Deficiencies |
12/21/2004 |
exits that are free from obstructions and can be used at all times. |
Isolated |
Minimal harm or potential for actual harm |
| Interior Finish Deficiencies |
12/21/2004 |
fire-resistant room wall surfaces. |
Widespread |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
01/11/2006 |
corridors that are separated from common areas by walls constructed to limit the passage of smoke. |
Pattern |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
01/11/2006 |
a fire alarm system that can be heard throughout the facility. |
Widespread |
Minimal harm or potential for actual harm |