|
Date of Survey
|
2007/05/11 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Environmental Deficiencies
|
|
Deficiency
|
Provide rooms that are big enough for each resident.
|
|
Level of Harm
|
Potential for minimal harm
|
|
|
Date of Survey
|
2007/05/11 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Resident Rights Deficiencies
|
|
Deficiency
|
Keep each resident's personal and medical records private and confidential.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/11 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Resident Rights Deficiencies
|
|
Deficiency
|
Let residents give themselves their drugs if they are able.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/11 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Resident Rights Deficiencies
|
|
Deficiency
|
Provide care in a way that keeps or builds each resident's dignity and self respect.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/11 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
Give each resident care and services to get or keep the highest quality of life possible.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/11 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/11 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Environmental Deficiencies
|
|
Deficiency
|
Make sure that the nursing home area is free of dangers that cause accidents.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/11 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Pharmacy Service Deficiencies
|
|
Deficiency
|
Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/11 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Environmental Deficiencies
|
|
Deficiency
|
Have a program to keep infection from spreading.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/08 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Smoke Compartmentation and Control Deficiencies
|
|
Deficiency
|
smoke barrier doors that can resist smoke for at least 20 minutes.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/08 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Hazardous Area Deficiencies
|
|
Deficiency
|
construction that can resist fire for one hour or an approved fire extinguishing system.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/08 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Fire Alarm Systems Deficiencies
|
|
Deficiency
|
an approved installation, maintenance and testing program for fire alarm systems.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/08 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Automatic Sprinkler Systems Deficiencies
|
|
Deficiency
|
automatic sprinkler systems that have been maintained in working order.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/08 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Electrical Deficiencies
|
|
Deficiency
|
weekly inspections and monthly testing of generators.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Administration Deficiencies
|
|
Deficiency
|
Keep accurate and appropriate medical records.
|
|
Level of Harm
|
Potential for minimal harm
|
|
|
Date of Survey
|
2006/06/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Environmental Deficiencies
|
|
Deficiency
|
Provide rooms that are big enough for each resident.
|
|
Level of Harm
|
Potential for minimal harm
|
|
|
Date of Survey
|
2006/06/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Nutrition and Dietary Deficiencies
|
|
Deficiency
|
Store, cook, and give out food in a safe and clean way.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Nutrition and Dietary Deficiencies
|
|
Deficiency
|
Make sure that the attending doctor orders special diets.
|
|
Level of Harm
|
Potential for minimal harm
|
|
|
Date of Survey
|
2006/06/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Environmental Deficiencies
|
|
Deficiency
|
Make sure that the nursing home area is free of dangers that cause accidents.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Resident Rights Deficiencies
|
|
Deficiency
|
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.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Environmental Deficiencies
|
|
Deficiency
|
Provide needed housekeeping and maintenance.
|
|
Level of Harm
|
Potential for minimal harm
|
|
|
Date of Survey
|
2006/06/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
Give professional services that follow each resident's written care plan.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
Give each resident care and services to get or keep the highest quality of life possible.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
Make sure that each resident who enters the nursing home without a catheter is not given a catheter, unless it is necessary.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/09/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Environmental Deficiencies
|
|
Deficiency
|
Provide needed housekeeping and maintenance.
|
|
Level of Harm
|
Potential for minimal harm
|
|
|
Date of Survey
|
2005/09/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Resident Assessment Deficiencies
|
|
Deficiency
|
Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.
|
|
Level of Harm
|
Potential for minimal harm
|
|
|
Date of Survey
|
2005/09/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
Make sure that each resident who enters the nursing home without a catheter is not given a catheter, unless it is necessary.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/09/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Environmental Deficiencies
|
|
Deficiency
|
Make sure that the nursing home area is free of dangers that cause accidents.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/09/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Nutrition and Dietary Deficiencies
|
|
Deficiency
|
Make sure that residents are well nourished.
|
|
Level of Harm
|
Potential for minimal harm
|
|
|
Date of Survey
|
2005/09/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Nutrition and Dietary Deficiencies
|
|
Deficiency
|
Make sure that the attending doctor orders special diets.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/09/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Nutrition and Dietary Deficiencies
|
|
Deficiency
|
1) Provide 3 meals daily at regular times; or 2) serve breakfast within 14 hours after dinner; or 3) offer a snack at bedtime each day.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/09/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Nutrition and Dietary Deficiencies
|
|
Deficiency
|
Store, cook, and give out food in a safe and clean way.
|
|
Level of Harm
|
Potential for minimal harm
|
|
|
Date of Survey
|
2005/09/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Environmental Deficiencies
|
|
Deficiency
|
Provide rooms that are big enough for each resident.
|
|
Level of Harm
|
Potential for minimal harm
|
|
|
Date of Survey
|
2005/09/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Administration Deficiencies
|
|
Deficiency
|
Give or get lab tests to meet the needs of residents.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/09/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
Provide activities to meet the needs of each resident.
|
|
Level of Harm
|
Potential for minimal harm
|
|