| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Administration Deficiencies |
10/30/2003 |
Hire a qualified activities director. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
10/30/2003 |
Hire a qualified social worker; or in homes with more than 120 beds, hire a qualified full-time social worker. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
10/30/2003 |
Get proof that a nurse aide has the training and skills that the State requires. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
10/30/2003 |
Make sure that nurse aides show they have the skills to be able to care for residents. |
Pattern |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
10/30/2003 |
Give or get lab tests to meet the needs of residents. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
10/30/2003 |
Provide needed housekeeping and maintenance. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
10/30/2003 |
Keep all essential equipment working safely. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
10/30/2003 |
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 |
10/30/2003 |
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 |
10/30/2003 |
Make sure that residents are well nourished. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
10/30/2003 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
10/30/2003 |
Give professional services that meet a professional standard of quality. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
10/30/2003 |
Give professional services that follow each resident's written care plan. |
Isolated |
Actual harm |
| Quality Care Deficiencies |
10/30/2003 |
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 |
10/30/2003 |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Isolated |
Actual harm |
| Quality Care Deficiencies |
10/30/2003 |
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 |
10/30/2003 |
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 |
| Resident Assessment Deficiencies |
10/30/2003 |
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 |
10/30/2003 |
Check and update (if needed) each resident's assessment every 3 months. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
10/30/2003 |
Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them. |
Isolated |
Actual harm |
| Resident Assessment Deficiencies |
10/30/2003 |
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 |
| Environmental Deficiencies |
07/28/2004 |
Get rid of garbage properly. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
07/28/2004 |
Make sure that the nursing home area is safe, easy to use, clean and comfortable. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
07/28/2004 |
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 Rights Deficiencies |
07/28/2004 |
Honor all of the resident's rights as a resident of the nursing home and as a citizen or resident of the United States. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
07/28/2004 |
Keep each resident's personal and medical records private and confidential. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
07/28/2004 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
11/17/2005 |
Quickly tell the resident's doctor the results of lab tests. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
11/17/2005 |
Keep accurate and appropriate medical records. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
11/17/2005 |
Get rid of garbage properly. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
11/17/2005 |
Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection. |
Widespread |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
11/17/2005 |
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 |
11/17/2005 |
Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
11/17/2005 |
Make sure that the attending doctor orders special diets. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
11/17/2005 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
11/17/2005 |
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 |
11/17/2005 |
Make sure that residents are safe from serious medication errors. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
11/17/2005 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
11/17/2005 |
Give professional services that follow each resident's written care plan. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
11/17/2005 |
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 |
11/17/2005 |
Make sure that each resident's nutritional needs were met. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
11/17/2005 |
Give each resident enough fluids to keep them healthy and prevent dehydration. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
11/17/2005 |
Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
11/17/2005 |
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 |
11/17/2005 |
Tell each resident who can get Medicaid benefits about 1) which items and services Medicaid covers and which the resident must pay for; or 2) how to apply for Medicaid, along with the names and addresses of State groups that can help. |
Widespread |
Potential for minimal harm |
| Resident Rights Deficiencies |
11/17/2005 |
Keep each resident's personal and medical records private and confidential. |
Pattern |
Potential for minimal harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Building Service Equipment Deficiencies |
11/15/2005 |
heating and ventilation systems that have been properly installed according to the manufacturer's instructions. |
Widespread |
Potential for minimal harm |
| Building Service Equipment Deficiencies |
11/15/2005 |
properly protected cooking facilities. |
Isolated |
Minimal harm or potential for actual harm |
| Emergency Plans and Fire Drills Deficiencies |
11/15/2005 |
record of quarterly fire drills for each shift under varying conditions. |
Pattern |
Minimal harm or potential for actual harm |
| Exits and Egress Deficiencies |
11/15/2005 |
exits that are accessible at all times. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
11/15/2005 |
an approved installation, maintenance and testing program for fire alarm systems. |
Isolated |
Minimal harm or potential for actual harm |