| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Environmental Deficiencies |
05/07/2004 |
Provide needed housekeeping and maintenance. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
05/07/2004 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
05/07/2004 |
Have a program to keep infection from spreading. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
05/07/2004 |
Make sure that staff members wash their hands when needed. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
05/07/2004 |
Make sure that the nursing home area is safe, easy to use, clean and comfortable. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
05/07/2004 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/07/2004 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/07/2004 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/07/2004 |
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 |
05/07/2004 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Actual harm |
| Resident Rights Deficiencies |
05/07/2004 |
Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
05/07/2004 |
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 |
05/13/2005 |
Make sure that the nursing home area is safe, easy to use, clean and comfortable. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
05/13/2005 |
Make sure that residents are well nourished. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/13/2005 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/13/2005 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/13/2005 |
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 Assessment Deficiencies |
05/13/2005 |
Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them. |
Pattern |
Potential for minimal harm |
| Environmental Deficiencies |
05/26/2006 |
Make sure that the nursing home area is safe, easy to use, clean and comfortable. |
Widespread |
Potential for minimal harm |
| Nutrition and Dietary Deficiencies |
05/26/2006 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Potential for minimal harm |
| Quality Care Deficiencies |
05/26/2006 |
Give each resident care and services to get or keep the highest quality of life possible. |
Isolated |
Actual harm |
| Resident Rights Deficiencies |
05/26/2006 |
Keep each resident's personal and medical records private and confidential. |
Pattern |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Corridor Walls and Doors Deficiencies |
05/06/2004 |
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 |
05/06/2004 |
corridor and hallway doors that block smoke. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
05/06/2004 |
a fire alarm system that can be heard throughout the facility. |
Widespread |
Minimal harm or potential for actual harm |
| Furnishings and Decorations Deficiencies |
05/06/2004 |
exits that are free from obstructions and can be used at all times. |
Isolated |
Minimal harm or potential for actual harm |
| Hazardous Area Deficiencies |
05/06/2004 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Isolated |
Minimal harm or potential for actual harm |
| Medical Gases and Anesthetizing Areas Deficiencies |
05/06/2004 |
proper medical gas storage and administration areas. |
Isolated |
Minimal harm or potential for actual harm |
| Miscellaneous Deficiencies |
05/06/2004 |
fire safety features required by current fire safety codes. |
Pattern |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
05/06/2004 |
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 |
| Automatic Sprinkler Systems Deficiencies |
05/26/2006 |
back-up procedures in place for a faulty automatic sprinkler system. |
Widespread |
Minimal harm or potential for actual harm |
| Building Contruction Deficiencies |
05/26/2006 |
approved construction type or materials. |
Isolated |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
05/26/2006 |
properly installed electrical wiring and equipment. |
Pattern |
Minimal harm or potential for actual harm |
| Exits and Egress Deficiencies |
05/26/2006 |
exits that are accessible at all times. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
05/26/2006 |
an approved installation, maintenance and testing program for fire alarm systems. |
Widespread |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
05/26/2006 |
properly maintained smoke detectors. |
Widespread |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
05/26/2006 |
an approved back-up procedure for a faulty fire alarm system. |
Widespread |
Minimal harm or potential for actual harm |