| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Administration Deficiencies |
01/08/2004 |
1) Review the work of each nurse aide every year; or 2) give regular training for the nurse aides. |
Pattern |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
01/08/2004 |
Keep accurate and appropriate medical records. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/08/2004 |
Keep safe, clean and homelike surroundings. |
Pattern |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
01/08/2004 |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
01/08/2004 |
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 |
01/08/2004 |
Make sure that residents are safe from serious medication errors. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
01/08/2004 |
Provide drugs and related services needed by each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
01/08/2004 |
Use the services of a licensed pharmacist. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/08/2004 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/08/2004 |
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 |
| Resident Assessment Deficiencies |
01/08/2004 |
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 |
01/08/2004 |
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 |
01/08/2004 |
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. |
Pattern |
Potential for minimal harm |
| Resident Rights Deficiencies |
01/08/2004 |
Try to resolve each resident's complaints quickly. |
Pattern |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
11/19/2004 |
Give or get lab tests to meet the needs of residents. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
11/19/2004 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Immediate jeopardy to resident health or safety |
| Environmental Deficiencies |
11/19/2004 |
Have a program to keep infection from spreading. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
11/19/2004 |
Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection. |
Pattern |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
11/19/2004 |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Isolated |
Immediate jeopardy to resident health or safety |
| Mistreatment Deficiencies |
11/19/2004 |
Keep each resident free from drugs that restrain them, unless needed for medical treatment. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
11/19/2004 |
Make sure that the attending doctor orders special diets. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
11/19/2004 |
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. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
11/19/2004 |
Make sure that residents are safe from serious medication errors. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
11/19/2004 |
Use the services of a licensed pharmacist. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
11/19/2004 |
Properly mark drugs and other similar products. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
11/19/2004 |
Keep drugs and other similar products locked safely and properly stored. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
11/19/2004 |
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 |
11/19/2004 |
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 |
11/19/2004 |
Make sure that each resident's nutritional needs were met. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
11/19/2004 |
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 |
11/19/2004 |
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 |
11/19/2004 |
Check and update (if needed) each resident's assessment every 3 months. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
11/19/2004 |
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 |
11/19/2004 |
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 |
11/19/2004 |
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 |
11/19/2004 |
Keep each resident's personal and medical records private and confidential. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
11/19/2004 |
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 |
12/08/2005 |
Hire a qualified activities director. |
Pattern |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
12/08/2005 |
Keep accurate and appropriate medical records. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
12/08/2005 |
Have a detailed, written plan for disasters and emergencies. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/08/2005 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
12/08/2005 |
Have a program to keep infection from spreading. |
Pattern |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
12/08/2005 |
Act when the pharmacist reports something unusual. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/08/2005 |
Provide activities to meet the needs of each resident. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
12/08/2005 |
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 |
12/08/2005 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Actual harm |
| Quality Care Deficiencies |
12/08/2005 |
Make sure that each resident's nutritional needs were met. |
Isolated |
Actual harm |
| Resident Assessment Deficiencies |
12/08/2005 |
Make a complete assessment that covers all questions for areas that are listed in official regulations. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
12/08/2005 |
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 |
12/08/2005 |
Keep each resident's personal and medical records private and confidential. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
12/08/2005 |
Provide services to meet the needs and preferences of each resident. |
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 |
01/07/2004 |
corridors that are separated from common areas by walls constructed to limit the passage of smoke. |
Widespread |
Potential for minimal harm |
| Corridor Walls and Doors Deficiencies |
01/07/2004 |
corridor and hallway doors that block smoke. |
Widespread |
Potential for minimal harm |
| Exits and Egress Deficiencies |
01/07/2004 |
exits that are accessible at all times. |
Widespread |
Potential for minimal harm |
| Hazardous Area Deficiencies |
01/07/2004 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Widespread |
Potential for minimal harm |
| Illumination and Emergency Power Deficiencies |
01/07/2004 |
emergency lighting that can last at least 1 1/2 hours. |
Widespread |
Immediate jeopardy to resident health or safety |
| Electrical Deficiencies |
12/06/2005 |
weekly inspections and monthly testing of generators. |
Widespread |
Potential for minimal harm |
| Illumination and Emergency Power Deficiencies |
12/06/2005 |
emergency lighting that can last at least 1 1/2 hours. |
Widespread |
Potential for minimal harm |