| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Administration Deficiencies |
03/25/2004 |
Keep accurate and appropriate medical records. |
Pattern |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
03/25/2004 |
Set up or keep a group of people to review and ensure quality. |
Widespread |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
03/25/2004 |
Keep safe, clean and homelike surroundings. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
03/25/2004 |
Make sure that a working call system is available in each resident's room or bathroom and bathing area. |
Pattern |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
03/25/2004 |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Isolated |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
03/25/2004 |
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 |
| Quality Care Deficiencies |
03/25/2004 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
03/25/2004 |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
03/25/2004 |
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 |
03/25/2004 |
Make sure each resident has the right to choose activities, schedules and health care according to his or her interests, assessment, and plan of care. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
02/25/2005 |
Be administered in a way that leads to the highest possible level of well being for each resident. |
Isolated |
Immediate jeopardy to resident health or safety |
| Administration Deficiencies |
02/25/2005 |
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 |
02/25/2005 |
Make sure that nurse aides show they have the skills to be able to care for residents. |
Pattern |
Potential for minimal harm |
| Administration Deficiencies |
02/25/2005 |
Keep accurate and appropriate medical records. |
Pattern |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
02/25/2005 |
Set up or keep a group of people to review and ensure quality. |
Widespread |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
02/25/2005 |
Keep safe, clean and homelike surroundings. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
02/25/2005 |
Provide needed housekeeping and maintenance. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
02/25/2005 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Immediate jeopardy to resident health or safety |
| Environmental Deficiencies |
02/25/2005 |
Have a program to keep infection from spreading. |
Widespread |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
02/25/2005 |
Keep all essential equipment working safely. |
Isolated |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
02/25/2005 |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
02/25/2005 |
Provide activities to meet the needs of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
02/25/2005 |
Make sure that each residents' abilities to take care of themselves does not lessen, unless a change cannot be avoided. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
02/25/2005 |
Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
02/25/2005 |
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 |
02/25/2005 |
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 |
02/25/2005 |
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 |
| Quality Care Deficiencies |
02/25/2005 |
Use a registered nurse at least 8 hours a day, 7 days a week. |
Widespread |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
02/25/2005 |
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 |
02/25/2005 |
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 |
02/25/2005 |
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 |
02/25/2005 |
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 |
02/25/2005 |
Allow residents to easily see the results of the nursing home's most recent survey. |
Widespread |
Potential for minimal harm |
| Resident Rights Deficiencies |
02/25/2005 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Pattern |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
01/13/2006 |
Be administered in a way that leads to the highest possible level of well being for each resident. |
Pattern |
Immediate jeopardy to resident health or safety |
| Administration Deficiencies |
01/13/2006 |
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 |
01/13/2006 |
Keep accurate and appropriate medical records. |
Pattern |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
01/13/2006 |
Set up or keep a group of people to review and ensure quality. |
Widespread |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/13/2006 |
Provide needed housekeeping and maintenance. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/13/2006 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Actual harm |
| Environmental Deficiencies |
01/13/2006 |
Have a program to keep infection from spreading. |
Widespread |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/13/2006 |
Keep all essential equipment working safely. |
Pattern |
Potential for minimal harm |
| Environmental Deficiencies |
01/13/2006 |
Make sure that a working call system is available in each resident's room or bathroom and bathing area. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/13/2006 |
Make sure there is a program to prevent/deal with mice, insects, or other pests. |
Pattern |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
01/13/2006 |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/13/2006 |
Make sure that residents are well nourished. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/13/2006 |
Provide food in a way that meets a resident's needs. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/13/2006 |
Make sure that the attending doctor orders special diets. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/13/2006 |
Store, cook, and give out food in a safe and clean way. |
Pattern |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
01/13/2006 |
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 |
01/13/2006 |
Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
01/13/2006 |
Have drugs and other similar products available, which are needed every day and in emergencies, and give them out properly. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
01/13/2006 |
Provide drugs and related services needed by each resident. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
01/13/2006 |
Make sure that the pharmacist reports anything unusual to the doctor on duty and the director of nursing. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
01/13/2006 |
Act when the pharmacist reports something unusual. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/13/2006 |
Provide activities to meet the needs of each resident. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/13/2006 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/13/2006 |
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 |
01/13/2006 |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Pattern |
Immediate jeopardy to resident health or safety |
| Quality Care Deficiencies |
01/13/2006 |
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 |
01/13/2006 |
Give proper treatment to residents with feeding tubes to prevent problems (such as aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, nasal-pharyngeal ulcers) and help restore eating skills, if possible. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/13/2006 |
Give or get dental care for each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
01/13/2006 |
Make a complete assessment that covers all questions for areas that are listed in official regulations. |
Pattern |
Immediate jeopardy to resident health or safety |
| Resident Assessment Deficiencies |
01/13/2006 |
Do an assessment of the resident every year. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
01/13/2006 |
Check and update (if needed) each resident's assessment every 3 months. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
01/13/2006 |
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 |
01/13/2006 |
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 Rights Deficiencies |
01/13/2006 |
Tell the resident completely about his or her health status. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
01/13/2006 |
Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged. |
Isolated |
Immediate jeopardy to resident health or safety |
| Resident Rights Deficiencies |
01/13/2006 |
Keep each resident's personal and medical records private and confidential. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
01/13/2006 |
Have a private telephone available for use. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
01/13/2006 |
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 |
01/13/2006 |
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: |
| Electrical Deficiencies |
03/25/2004 |
a separate and independent backup electrical power source. |
Widespread |
Potential for minimal harm |
| Electrical Deficiencies |
03/25/2004 |
properly installed electrical wiring and equipment. |
Widespread |
Potential for minimal harm |
| Smoke Compartmentation and Control Deficiencies |
03/25/2004 |
walls or barriers that prevent smoke from passing through and would resist fire for at least one hour. |
Widespread |
Potential for minimal harm |
| Electrical Deficiencies |
02/22/2005 |
properly installed electrical wiring and equipment. |
Isolated |
Minimal harm or potential for actual harm |
| Medical Gases and Anesthetizing Areas Deficiencies |
02/22/2005 |
proper medical gas storage and administration areas. |
Pattern |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
02/22/2005 |
smoke barrier doors that can resist smoke for at least 20 minutes. |
Isolated |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
01/10/2006 |
corridor and hallway doors that block smoke. |
Pattern |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
01/10/2006 |
a separate and independent backup electrical power source. |
Pattern |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
01/10/2006 |
walls or barriers that prevent smoke from passing through and would resist fire for at least one hour. |
Pattern |
Minimal harm or potential for actual harm |