| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Environmental Deficiencies |
05/13/2004 |
Provide needed housekeeping and maintenance. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
05/13/2004 |
Get rid of garbage properly. |
Widespread |
Potential for minimal harm |
| Environmental Deficiencies |
05/13/2004 |
Put firmly secured handrails on each side of hallways. |
Isolated |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
05/13/2004 |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Pattern |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
05/13/2004 |
1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
05/13/2004 |
Provide food in a way that meets a resident's needs. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
05/13/2004 |
Offer other nutritional food to each resident who will not eat the food served. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
05/13/2004 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/13/2004 |
Provide activities to meet the needs of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/13/2004 |
Give professional services that follow each resident's written care plan. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/13/2004 |
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 |
05/13/2004 |
Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
05/13/2004 |
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 |
05/13/2004 |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Isolated |
Actual harm |
| Quality Care Deficiencies |
05/13/2004 |
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 |
05/13/2004 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Actual harm |
| Resident Assessment Deficiencies |
05/13/2004 |
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 |
05/13/2004 |
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 |
05/13/2004 |
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 |
06/17/2005 |
Provide needed housekeeping and maintenance. |
Pattern |
Potential for minimal harm |
| Nutrition and Dietary Deficiencies |
06/17/2005 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
06/17/2005 |
Keep drugs and other similar products locked safely and properly stored. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
06/17/2005 |
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 |
06/17/2005 |
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 |
| Environmental Deficiencies |
07/27/2006 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
07/27/2006 |
Provide social services for related medical problems to help each resident achieve the highest possible quality of life. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
07/27/2006 |
Make a complete assessment that covers all questions for areas that are listed in official regulations. |
Pattern |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Corridor Walls and Doors Deficiencies |
05/12/2004 |
corridor and hallway doors that block smoke. |
Isolated |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
05/12/2004 |
weekly inspections and monthly testing of generators. |
Isolated |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
05/12/2004 |
properly installed electrical wiring and equipment. |
Pattern |
Minimal harm or potential for actual harm |
| Medical Gases and Anesthetizing Areas Deficiencies |
05/12/2004 |
no-smoking signs where oxygen is used. |
Isolated |
Minimal harm or potential for actual harm |
| Vertical Openings Deficiencies |
05/12/2004 |
proper stairway enclosures and vertical shafts. |
Pattern |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
06/15/2005 |
automatic sprinkler systems that have been maintained in working order. |
Isolated |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
06/15/2005 |
portable fire extinguishers. |
Isolated |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
06/15/2005 |
corridor and hallway doors that block smoke. |
Pattern |
Minimal harm or potential for actual harm |
| Medical Gases and Anesthetizing Areas Deficiencies |
06/15/2005 |
proper medical gas storage and administration areas. |
Isolated |
Minimal harm or potential for actual harm |
| Vertical Openings Deficiencies |
06/15/2005 |
proper stairway enclosures and vertical shafts. |
Pattern |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
07/26/2006 |
automatic sprinkler systems that have been maintained in working order. |
Pattern |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
07/26/2006 |
corridor and hallway doors that block smoke. |
Isolated |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
07/26/2006 |
smoke barrier doors that can resist smoke for at least 20 minutes. |
Isolated |
Minimal harm or potential for actual harm |
| Vertical Openings Deficiencies |
07/26/2006 |
proper stairway enclosures and vertical shafts. |
Isolated |
Minimal harm or potential for actual harm |