| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Administration Deficiencies |
11/04/2004 |
Keep accurate and appropriate medical records. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
11/04/2004 |
Provide needed housekeeping and maintenance. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
11/04/2004 |
Provide food in a way that meets a resident's needs. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
11/04/2004 |
Provide special eating equipment and utensils for each resident who needs them. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
11/04/2004 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
11/04/2004 |
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 |
11/04/2004 |
Make sure that residents are safe from serious medication errors. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
11/04/2004 |
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 |
11/04/2004 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
11/04/2004 |
Keep each resident's personal and medical records private and confidential. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
11/04/2004 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
08/04/2005 |
Make sure that nurse aides show they have the skills to be able to care for residents. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
08/04/2005 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
08/04/2005 |
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 |
| Nutrition and Dietary Deficiencies |
08/04/2005 |
Make sure that residents are well nourished. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
08/04/2005 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
08/04/2005 |
Give professional services that meet a professional standard of quality. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
08/04/2005 |
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 |
08/04/2005 |
Have enough nurses to care for every resident in a way that maximizes the resident's well being. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
08/04/2005 |
Check and update (if needed) each resident's assessment every 3 months. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
08/04/2005 |
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 Assessment Deficiencies |
08/04/2005 |
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 |
| Resident Assessment Deficiencies |
08/04/2005 |
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. |
Pattern |
Potential for minimal harm |
| Resident Assessment Deficiencies |
08/04/2005 |
Develop a plan with the resident and family for the resident's care after leaving the nursing home. |
Pattern |
Potential for minimal harm |
| Resident Assessment Deficiencies |
08/04/2005 |
Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing. |
Pattern |
Potential for minimal harm |
| Resident Assessment Deficiencies |
08/04/2005 |
Make sure that doctors visit residents regularly, as required. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
08/04/2005 |
Try to resolve each resident's complaints quickly. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
08/04/2005 |
Let residents give themselves their drugs if they are able. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
08/04/2005 |
Provide written records when a resident is transferred or discharged. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
08/04/2005 |
Provide enough notice before discharging or transferring a resident. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
08/04/2005 |
Tell the resident or the resident's representative in writing how long the nursing home will hold the resident's bed when the resident temporarily leaves the facility. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
08/04/2005 |
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 |
| Resident Rights Deficiencies |
08/04/2005 |
Provide services to meet the needs and preferences of each resident. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
07/20/2006 |
Make sure there is a program to prevent/deal with mice, insects, or other pests. |
Widespread |
Potential for minimal harm |
| Pharmacy Service Deficiencies |
07/20/2006 |
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 |
07/20/2006 |
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 |
07/20/2006 |
At least once a month, have a licensed pharmacist check the drugs that each resident takes. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
07/20/2006 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
07/20/2006 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Medical Gases and Anesthetizing Areas Deficiencies |
11/03/2004 |
proper medical gas storage and administration areas. |
Pattern |
Minimal harm or potential for actual harm |
| Emergency Plans and Fire Drills Deficiencies |
07/19/2006 |
record of quarterly fire drills for each shift under varying conditions. |
Widespread |
Minimal harm or potential for actual harm |