| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Administration Deficiencies |
08/06/2004 |
Set up or keep a group of people to review and ensure quality. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
08/06/2004 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
08/06/2004 |
Store, cook, and give out food in a safe and clean way. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
08/06/2004 |
Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
08/06/2004 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Actual harm |
| Resident Assessment Deficiencies |
08/06/2004 |
Electronically record and report resident status assessments in a timely manner as required in order to monitor resident health and progress. |
Pattern |
Potential for minimal harm |
| Resident Rights Deficiencies |
08/06/2004 |
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 |
Potential for minimal harm |
| Resident Rights Deficiencies |
08/06/2004 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Pattern |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
10/28/2005 |
Follow all laws and professional standards. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
10/28/2005 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
10/28/2005 |
Make sure that residents are well nourished. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
10/28/2005 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
10/28/2005 |
Give professional services that meet a professional standard of quality. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
10/28/2005 |
Give proper treatment to residents with feeding tubes to prevent problems (such as aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, nasal-pharyngeal ulcers) and help restore eating skills, if possible. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
10/28/2005 |
Give each resident a special diet to help when there is a nutritional problem. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
10/28/2005 |
Make sure that doctors visit residents regularly, as required. |
Pattern |
Potential for minimal harm |
| Environmental Deficiencies |
10/06/2006 |
Provide needed housekeeping and maintenance. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
10/06/2006 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
10/06/2006 |
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. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
10/06/2006 |
Give each resident care and services to get or keep the highest quality of life possible. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
10/06/2006 |
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 |
10/06/2006 |
Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
10/06/2006 |
Keep each resident's personal and medical records private and confidential. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Automatic Sprinkler Systems Deficiencies |
08/04/2004 |
an approved automatic sprinkler system connected to the fire alarm system. |
Isolated |
Minimal harm or potential for actual harm |
| Building Contruction Deficiencies |
08/04/2004 |
approved construction type or materials. |
Isolated |
Minimal harm or potential for actual harm |
| Medical Gases and Anesthetizing Areas Deficiencies |
08/04/2004 |
proper medical gas storage and administration areas. |
Isolated |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
08/04/2004 |
walls or barriers that prevent smoke from passing through and would resist fire for at least one hour. |
Pattern |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
11/02/2005 |
an approved automatic sprinkler system connected to the fire alarm system. |
Widespread |
Minimal harm or potential for actual harm |
| Building Service Equipment Deficiencies |
11/02/2005 |
properly protected cooking facilities. |
Widespread |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
11/02/2005 |
corridors that are separated from common areas by walls constructed to limit the passage of smoke. |
Isolated |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
11/02/2005 |
corridor and hallway doors that block smoke. |
Isolated |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
11/02/2005 |
properly installed electrical wiring and equipment. |
Widespread |
Minimal harm or potential for actual harm |
| Hazardous Area Deficiencies |
11/02/2005 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Widespread |
Minimal harm or potential for actual harm |
| Illumination and Emergency Power Deficiencies |
11/02/2005 |
emergency lighting that can last at least 1 1/2 hours. |
Widespread |
Minimal harm or potential for actual harm |
| Illumination and Emergency Power Deficiencies |
11/02/2005 |
properly located and lighted Exit signs. |
Isolated |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
11/02/2005 |
walls or barriers that prevent smoke from passing through and would resist fire for at least one hour. |
Isolated |
Minimal harm or potential for actual harm |
| Smoking Regulations Deficiencies |
11/02/2005 |
posted No-smoking signs in areas where smoking is not permitted or did not provide ashtrays where smoking was allowed. |
Isolated |
Minimal harm or potential for actual harm |
| Vertical Openings Deficiencies |
11/02/2005 |
exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detectors. |
Widespread |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
10/12/2006 |
an approved automatic sprinkler system connected to the fire alarm system. |
Isolated |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
10/12/2006 |
corridor and hallway doors that block smoke. |
Pattern |
Minimal harm or potential for actual harm |
| Furnishings and Decorations Deficiencies |
10/12/2006 |
restrictions on the use of flammable curtains. |
Isolated |
Minimal harm or potential for actual harm |
| Hazardous Area Deficiencies |
10/12/2006 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Isolated |
Minimal harm or potential for actual harm |
| Illumination and Emergency Power Deficiencies |
10/12/2006 |
emergency lighting that can last at least 1 1/2 hours. |
Widespread |
Minimal harm or potential for actual harm |
| Laboratories Deficiencies |
10/12/2006 |
proper facilities for the use and storage of combustible liquids. |
Isolated |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
10/12/2006 |
walls or barriers that prevent smoke from passing through and would resist fire for at least one hour. |
Isolated |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
10/12/2006 |
smoke barrier doors that can resist smoke for at least 20 minutes. |
Isolated |
Minimal harm or potential for actual harm |
| Smoking Regulations Deficiencies |
10/12/2006 |
posted No-smoking signs in areas where smoking is not permitted or did not provide ashtrays where smoking was allowed. |
Isolated |
Minimal harm or potential for actual harm |