| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Environmental Deficiencies |
04/08/2004 |
Provide needed housekeeping and maintenance. |
Pattern |
Potential for minimal harm |
| Environmental Deficiencies |
04/08/2004 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Pattern |
Immediate jeopardy to resident health or safety |
| Environmental Deficiencies |
04/08/2004 |
Make sure that the nursing home area is safe, easy to use, clean and comfortable. |
Widespread |
Potential for minimal harm |
| Nutrition and Dietary Deficiencies |
04/08/2004 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
04/08/2004 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
04/08/2004 |
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 |
04/08/2004 |
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 |
04/08/2004 |
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 |
| Quality Care Deficiencies |
04/08/2004 |
Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
04/08/2004 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Immediate jeopardy to resident health or safety |
| Quality Care Deficiencies |
04/08/2004 |
Give each resident enough fluids to keep them healthy and prevent dehydration. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
04/08/2004 |
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 Rights Deficiencies |
04/08/2004 |
Provide services to meet the needs and preferences of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
03/01/2005 |
Keep accurate and appropriate medical records. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
03/01/2005 |
Give each resident care and services to get or keep the highest quality of life possible. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
03/01/2005 |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
03/01/2005 |
Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
03/01/2005 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Actual harm |
| Resident Assessment Deficiencies |
03/01/2005 |
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 |
03/01/2005 |
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. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
03/01/2005 |
Provide services to meet the needs and preferences of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/12/2006 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/12/2006 |
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 |
01/12/2006 |
Make sure that each resident who enters the nursing home without a catheter is not given a catheter, unless it is necessary. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/12/2006 |
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 |
01/12/2006 |
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 |
01/12/2006 |
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 Rights Deficiencies |
01/12/2006 |
Properly hold, secure and manage each resident's personal money which is deposited with the nursing home. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
01/12/2006 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Automatic Sprinkler Systems Deficiencies |
04/07/2004 |
an approved automatic sprinkler system connected to the fire alarm system. |
Isolated |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
04/07/2004 |
automatic sprinkler systems that have been maintained in working order. |
Pattern |
Minimal harm or potential for actual harm |
| Building Service Equipment Deficiencies |
04/07/2004 |
an externally vented heating system. |
Isolated |
Minimal harm or potential for actual harm |
| Building Service Equipment Deficiencies |
04/07/2004 |
properly protected cooking facilities. |
Isolated |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
04/07/2004 |
corridor and hallway doors that block smoke. |
Pattern |
Minimal harm or potential for actual harm |
| Exits and Egress Deficiencies |
04/07/2004 |
exits that are accessible at all times. |
Pattern |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
04/07/2004 |
a fire alarm system that can be heard throughout the facility. |
Widespread |
Minimal harm or potential for actual harm |
| Furnishings and Decorations Deficiencies |
04/07/2004 |
exits that are free from obstructions and can be used at all times. |
Pattern |
Minimal harm or potential for actual harm |
| Hazardous Area Deficiencies |
04/07/2004 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Pattern |
Minimal harm or potential for actual harm |
| Illumination and Emergency Power Deficiencies |
04/07/2004 |
proper backup exit lighting. |
Isolated |
Minimal harm or potential for actual harm |
| Illumination and Emergency Power Deficiencies |
04/07/2004 |
emergency lighting that can last at least 1 1/2 hours. |
Isolated |
Minimal harm or potential for actual harm |
| Medical Gases and Anesthetizing Areas Deficiencies |
04/07/2004 |
proper medical gas storage and administration areas. |
Isolated |
Minimal harm or potential for actual harm |
| Miscellaneous Deficiencies |
04/07/2004 |
fire safety features required by current fire safety codes. |
Pattern |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
04/07/2004 |
walls or barriers that prevent smoke from passing through and would resist fire for at least one hour. |
Widespread |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
04/07/2004 |
smoke barrier doors that can resist smoke for at least 20 minutes. |
Isolated |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
03/22/2005 |
automatic sprinkler systems that have been maintained in working order. |
Isolated |
Minimal harm or potential for actual harm |
| Building Service Equipment Deficiencies |
03/22/2005 |
properly protected cooking facilities. |
Isolated |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
03/22/2005 |
corridor and hallway doors that block smoke. |
Widespread |
Minimal harm or potential for actual harm |
| Exits and Egress Deficiencies |
03/22/2005 |
exits that are accessible at all times. |
Pattern |
Minimal harm or potential for actual harm |
| Furnishings and Decorations Deficiencies |
03/22/2005 |
exits that are free from obstructions and can be used at all times. |
Pattern |
Minimal harm or potential for actual harm |
| Hazardous Area Deficiencies |
03/22/2005 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Pattern |
Minimal harm or potential for actual harm |
| Illumination and Emergency Power Deficiencies |
03/22/2005 |
emergency lighting that can last at least 1 1/2 hours. |
Isolated |
Minimal harm or potential for actual harm |
| Laboratories Deficiencies |
03/22/2005 |
emergency showers. |
Isolated |
Minimal harm or potential for actual harm |
| Medical Gases and Anesthetizing Areas Deficiencies |
03/22/2005 |
proper medical gas storage and administration areas. |
Isolated |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
01/19/2006 |
automatic sprinkler systems that have been maintained in working order. |
Isolated |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
01/19/2006 |
back-up procedures in place for a faulty automatic sprinkler system. |
Isolated |
Minimal harm or potential for actual harm |
| Building Contruction Deficiencies |
01/19/2006 |
approved construction type or materials. |
Isolated |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
01/19/2006 |
corridor and hallway doors that block smoke. |
Pattern |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
01/19/2006 |
properly installed electrical wiring and equipment. |
Pattern |
Minimal harm or potential for actual harm |
| Emergency Plans and Fire Drills Deficiencies |
01/19/2006 |
record of quarterly fire drills for each shift under varying conditions. |
Pattern |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
01/19/2006 |
an approved installation, maintenance and testing program for fire alarm systems. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
01/19/2006 |
an approved back-up procedure for a faulty fire alarm system. |
Isolated |
Minimal harm or potential for actual harm |
| Furnishings and Decorations Deficiencies |
01/19/2006 |
properly sized and located linen or trash receptacles. |
Isolated |
Minimal harm or potential for actual harm |
| Hazardous Area Deficiencies |
01/19/2006 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Pattern |
Minimal harm or potential for actual harm |
| Illumination and Emergency Power Deficiencies |
01/19/2006 |
emergency lighting that can last at least 1 1/2 hours. |
Isolated |
Minimal harm or potential for actual harm |
| Illumination and Emergency Power Deficiencies |
01/19/2006 |
properly located and lighted Exit signs. |
Isolated |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
01/19/2006 |
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 |
| Smoking Regulations Deficiencies |
01/19/2006 |
posted No-smoking signs in areas where smoking is not permitted or did not provide ashtrays where smoking was allowed. |
Pattern |
Minimal harm or potential for actual harm |