Administration Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
1) Review the work of each nurse aide every year; and 2) give regular in-service training based upon these reviews.
|
01/01/2011
|
02/00/2011
|
1
|
Some
|
Environmental Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible.
|
01/01/2011
|
02/09/2011
|
2
|
Some
|
Pharmacy Service Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being.
|
01/01/2011
|
02/00/2011
|
2
|
Few
|
|
Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.
|
01/01/2011
|
02/09/2011
|
2
|
Few
|
|
At least once a month, have a licensed pharmacist review each resident's medication(s) and report any irregularities to the attending doctor.
|
01/01/2011
|
02/00/2011
|
2
|
Few
|
Quality Care Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions.
|
01/01/2011
|
02/09/2011
|
3
|
Some
|
Resident Assessment Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Provide proper discharge planning and communication, of the resident's health status and summary of the resident's nursing home stay.
|
01/01/2011
|
02/03/2011
|
1
|
Some
|
Resident Rights Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Give residents a notice of rights, rules, services and charges.
|
01/01/2011
|
02/09/2011
|
1
|
Many
|
|
Keep residents' personal and medical records private and confidential.
|
01/01/2011
|
02/07/2011
|
1
|
Many
|
|
Provide care for residents in a way that maintains or improves their dignity and respect in full recognition of their individuality.
|
01/01/2011
|
02/04/2011
|
2
|
Some
|
Environmental Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents.
|
02/08/2002
|
02/08/2003
|
2
|
Few
|
|
Have a program that investigates, controls and keeps infection from spreading.
|
02/08/2002
|
02/08/2003
|
2
|
Few
|
|
Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents.
|
02/08/2002
|
02/08/2003
|
2
|
Few
|
Mistreatment Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
1) Hire only people with 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.
|
02/08/2002
|
02/08/2003
|
2
|
Few
|
|
Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property.
|
02/08/2002
|
02/08/2003
|
2
|
Few
|
|
1) Hire only people with 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.
|
02/08/2002
|
02/08/2003
|
2
|
Few
|
|
Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property.
|
02/08/2002
|
02/08/2003
|
2
|
Few
|
Pharmacy Service Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being.
|
02/08/2002
|
02/08/2003
|
2
|
Few
|
|
Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse.
|
02/08/2002
|
02/08/2003
|
2
|
Few
|
Quality Care Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions.
|
02/08/2002
|
02/08/2003
|
2
|
Few
|
|
Develop policies and procedures for influenza and pneumococcal immunizations.
|
02/08/2002
|
02/08/2003
|
2
|
Few
|
|
Have enough nurses to care for every resident in a way that maximizes the resident's well being.
|
02/08/2002
|
02/08/2003
|
2
|
Some
|
|
Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions.
|
02/08/2002
|
02/08/2003
|
2
|
Few
|
|
Have enough nurses to care for every resident in a way that maximizes the resident's well being.
|
02/08/2002
|
02/08/2003
|
2
|
Some
|
Resident Assessment Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Make sure that doctors visit residents regularly, as required.
|
02/08/2002
|
02/08/2003
|
2
|
Few
|
Resident Rights Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Ensure that residents are fully informed and understand their health status, care and treatments.
|
02/08/2002
|
02/08/2003
|
2
|
Few
|
Environmental Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible.
|
01/03/2001
|
01/03/2002
|
1
|
Some
|
|
Provide housekeeping and maintenance services.
|
01/03/2001
|
01/03/2002
|
2
|
Some
|
|
Have a program that investigates, controls and keeps infection from spreading.
|
01/03/2001
|
01/03/2002
|
2
|
Few
|
|
Keep all essential equipment working safely.
|
01/03/2001
|
01/03/2002
|
1
|
Some
|
|
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
|
01/03/2001
|
01/03/2002
|
1
|
Some
|
Nutrition and Dietary Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.
|
01/03/2001
|
01/03/2002
|
2
|
Few
|
|
Store, cook, and serve food in a safe and clean way.
|
01/03/2001
|
01/03/2002
|
2
|
Some
|
Pharmacy Service Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.
|
01/03/2001
|
01/03/2002
|
2
|
Few
|
|
Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse.
|
01/03/2001
|
01/03/2002
|
2
|
Some
|
|
Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse.
|
01/03/2001
|
01/03/2002
|
2
|
Some
|
Quality Care Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Provide necessary care and services to maintain or improve the highest well being of each resident.
|
01/03/2001
|
01/03/2002
|
2
|
Few
|
|
Assist those residents who need help with eating/drinking, grooming and personal and oral hygiene.
|
01/03/2001
|
01/03/2002
|
2
|
Few
|
|
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.
|
01/03/2001
|
01/03/2002
|
2
|
Few
|
|
Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions.
|
01/03/2001
|
01/03/2002
|
2
|
Few
|
Resident Rights Deficiencies
|
|
Deficiency
|
Inspection Date
|
Correction Date
|
Level of Harm
|
Residents Affected
|
|
Give residents a notice of rights, rules, services and charges.
|
01/03/2001
|
01/03/2002
|
1
|
Some
|