| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Administration Deficiencies |
03/19/2004 |
Keep accurate and appropriate medical records. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
03/19/2004 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
03/19/2004 |
Make sure that the nursing home area is safe, easy to use, clean and comfortable. |
Pattern |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
03/19/2004 |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
03/19/2004 |
Store, cook, and give out food in a safe and clean way. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
03/19/2004 |
Provide activities to meet the needs of each resident. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
03/19/2004 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
03/19/2004 |
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 |
03/19/2004 |
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 |
03/19/2004 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
03/19/2004 |
Make sure that each resident's nutritional needs were met. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
03/19/2004 |
Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
03/19/2004 |
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. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
03/19/2004 |
Keep each resident's personal and medical records private and confidential. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
03/19/2004 |
Have a private telephone available for use. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
03/19/2004 |
Use the same rules about transfer, discharge and providing services for all residents, no matter how they pay. |
Pattern |
Potential for minimal harm |
| Resident Rights Deficiencies |
03/19/2004 |
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 |
01/13/2005 |
Be administered in a way that leads to the highest possible level of well being for each resident. |
Widespread |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
01/13/2005 |
Keep accurate and appropriate medical records. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/13/2005 |
Keep safe, clean and homelike surroundings. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/13/2005 |
Provide needed housekeeping and maintenance. |
Pattern |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
01/13/2005 |
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 |
| Mistreatment Deficiencies |
01/13/2005 |
Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/13/2005 |
Make sure that residents are well nourished. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/13/2005 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/13/2005 |
Give professional services that meet a professional standard of quality. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/13/2005 |
Give professional services that follow each resident's written care plan. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/13/2005 |
Give each resident care and services to get or keep the highest quality of life possible. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/13/2005 |
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 |
01/13/2005 |
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 |
01/13/2005 |
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 |
01/13/2005 |
Give each resident enough fluids to keep them healthy and prevent dehydration. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/13/2005 |
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 |
01/13/2005 |
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. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
01/13/2005 |
Keep each resident's personal and medical records private and confidential. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
01/13/2005 |
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 |
01/13/2005 |
Provide services to meet the needs and preferences of each resident. |
Pattern |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
03/30/2006 |
Make sure that nurse aides show they have the skills to be able to care for residents. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
03/30/2006 |
Quickly tell the resident's doctor the results of lab tests. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
03/30/2006 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Widespread |
Potential for minimal harm |
| Environmental Deficiencies |
03/30/2006 |
Make sure there is a program to prevent/deal with mice, insects, or other pests. |
Widespread |
Potential for minimal harm |
| Nutrition and Dietary Deficiencies |
03/30/2006 |
Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. |
Pattern |
Potential for minimal harm |
| Nutrition and Dietary Deficiencies |
03/30/2006 |
Store, cook, and give out food in a safe and clean way. |
Pattern |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
03/30/2006 |
Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%. |
Pattern |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Corridor Walls and Doors Deficiencies |
03/19/2004 |
corridor and hallway doors that block smoke. |
Widespread |
Potential for minimal harm |
| Fire Alarm Systems Deficiencies |
03/19/2004 |
a fire alarm system that can be heard throughout the facility. |
Widespread |
Potential for minimal harm |
| Miscellaneous Deficiencies |
03/19/2004 |
fire safety features required by current fire safety codes. |
Widespread |
Potential for minimal harm |
| Automatic Sprinkler Systems Deficiencies |
01/11/2005 |
properly working sprinkler alarm system. |
Widespread |
Potential for minimal harm |
| Automatic Sprinkler Systems Deficiencies |
01/11/2005 |
properly working alarms on sprinkler valves. |
Widespread |
Potential for minimal harm |
| Electrical Deficiencies |
01/11/2005 |
weekly inspections and monthly testing of generators. |
Widespread |
Potential for minimal harm |
| Fire Alarm Systems Deficiencies |
01/11/2005 |
outside doors or windows in every resident room. |
Isolated |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
01/11/2005 |
smoke barrier doors that can resist smoke for at least 20 minutes. |
Isolated |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
03/29/2006 |
portable fire extinguishers. |
Widespread |
Potential for minimal harm |
| Corridor Walls and Doors Deficiencies |
03/29/2006 |
corridors that are separated from common areas by walls constructed to limit the passage of smoke. |
Widespread |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
03/29/2006 |
properly maintained smoke detectors. |
Widespread |
Potential for minimal harm |
| Hazardous Area Deficiencies |
03/29/2006 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Isolated |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
03/29/2006 |
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 |
| Smoking Regulations Deficiencies |
03/29/2006 |
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 |