| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Administration Deficiencies |
12/23/2004 |
Keep accurate and appropriate medical records. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/23/2004 |
Keep safe, clean and homelike surroundings. |
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 |
Make sure that staff members wash their hands when needed. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/23/2004 |
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 |
12/23/2004 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
12/23/2004 |
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. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/23/2004 |
Provide activities to meet the needs of each resident. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/23/2004 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/23/2004 |
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 |
12/23/2004 |
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 |
12/23/2004 |
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 |
12/23/2004 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
12/23/2004 |
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
12/23/2004 |
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 |
12/23/2004 |
Keep each resident's personal and medical records private and confidential. |
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 |
02/21/2006 |
Keep each resident free from drugs that restrain them, unless needed for medical treatment. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
02/21/2006 |
Make sure that residents are well nourished. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
02/21/2006 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
02/21/2006 |
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 |
02/21/2006 |
Provide drugs and related services needed by each resident. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
02/21/2006 |
Provide activities to meet the needs of each resident. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
02/21/2006 |
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 |
02/21/2006 |
Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
02/21/2006 |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
02/21/2006 |
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 |
| Quality Care Deficiencies |
02/21/2006 |
Make sure that each resident's nutritional needs were met. |
Isolated |
Actual harm |
| Quality Care Deficiencies |
02/21/2006 |
Give each resident enough fluids to keep them healthy and prevent dehydration. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
02/21/2006 |
Have enough nurses to care for every resident in a way that maximizes the resident's well being. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
02/21/2006 |
Do a new assessment after any major change in a resident's physical or mental health. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
02/21/2006 |
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. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
02/21/2006 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
02/21/2006 |
Provide services to meet the needs and preferences of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Corridor Walls and Doors Deficiencies |
10/28/2003 |
corridor and hallway doors that block smoke. |
Isolated |
Minimal harm or potential for actual harm |
| Vertical Openings Deficiencies |
10/28/2003 |
exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detectors. |
Isolated |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
11/29/2005 |
automatic sprinkler systems that have been maintained in working order. |
Widespread |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
11/29/2005 |
back-up procedures in place for a faulty automatic sprinkler system. |
Isolated |
Minimal harm or potential for actual harm |
| Building Contruction Deficiencies |
11/29/2005 |
a two-hour-resistant firewall in common walls. |
Isolated |
Minimal harm or potential for actual harm |
| Building Contruction Deficiencies |
11/29/2005 |
approved construction type or materials. |
Pattern |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
11/29/2005 |
corridor and hallway doors that block smoke. |
Widespread |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
11/29/2005 |
weekly inspections and monthly testing of generators. |
Widespread |
Potential for minimal harm |
| Emergency Plans and Fire Drills Deficiencies |
11/29/2005 |
record of quarterly fire drills for each shift under varying conditions. |
Pattern |
Minimal harm or potential for actual harm |
| Exits and Egress Deficiencies |
11/29/2005 |
exits that are accessible at all times. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
11/29/2005 |
a fire alarm system that can be heard throughout the facility. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
11/29/2005 |
an approved back-up procedure for a faulty fire alarm system. |
Isolated |
Minimal harm or potential for actual harm |
| Hazardous Area Deficiencies |
11/29/2005 |
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 |
11/29/2005 |
proper backup exit lighting. |
Pattern |
Minimal harm or potential for actual harm |
| Illumination and Emergency Power Deficiencies |
11/29/2005 |
emergency lighting that can last at least 1 1/2 hours. |
Isolated |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
11/29/2005 |
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 |
11/29/2005 |
smoke barrier doors that can resist smoke for at least 20 minutes. |
Pattern |
Minimal harm or potential for actual harm |
| Vertical Openings Deficiencies |
11/29/2005 |
protected exits that allow the resident to escape the building. |
Isolated |
Minimal harm or potential for actual harm |