|
Date of Survey
|
2007/06/15 (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
|
2007/06/15 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Environmental Deficiencies
|
|
Deficiency
|
Keep safe, clean and homelike surroundings.
|
|
Level of Harm
|
Potential for minimal harm
|
|
|
Date of Survey
|
2007/06/15 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Resident Assessment Deficiencies
|
|
Deficiency
|
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.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/06/15 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
Give professional services that meet a professional standard of quality.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/06/15 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
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.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/06/15 (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
|
2007/06/15 (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
|
2007/06/15 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
offer Flu or Pneumococal vaccine to some residents.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/06/15 (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
|
2007/06/15 (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
|
2007/06/15 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Environmental Deficiencies
|
|
Deficiency
|
Make sure that the nursing home area is safe, easy to use, clean and comfortable.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/06/15 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Environmental Deficiencies
|
|
Deficiency
|
Put firmly secured handrails on each side of hallways.
|
|
Level of Harm
|
Potential for minimal harm
|
|
|
Date of Survey
|
2007/04/12 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Automatic Sprinkler Systems Deficiencies
|
|
Deficiency
|
an approved automatic sprinkler system connected to the fire alarm system.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/04/12 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Illumination and Emergency Power Deficiencies
|
|
Deficiency
|
emergency lighting that can last at least 1 1/2 hours.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/03/23 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Administration Deficiencies
|
|
Deficiency
|
Keep accurate and appropriate medical records.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/03/23 (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
|
2006/03/23 (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
|
2006/03/23 (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
|
2006/03/23 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Resident Rights Deficiencies
|
|
Deficiency
|
Provide services to meet the needs and preferences of each resident.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/03/23 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Resident Assessment Deficiencies
|
|
Deficiency
|
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/03/23 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/03/23 (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
|
2006/03/23 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/02/04 (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
|
2005/02/04 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Resident Assessment Deficiencies
|
|
Deficiency
|
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/02/04 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Resident Assessment Deficiencies
|
|
Deficiency
|
Keep assessments completed in the preceding 15 months in the resident's active record.
|
|
Level of Harm
|
Potential for minimal harm
|
|
|
Date of Survey
|
2005/02/04 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/02/04 (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
|
2005/02/04 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Pharmacy Service Deficiencies
|
|
Deficiency
|
Make sure that residents are safe from serious medication errors.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/02/04 (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
|
2005/02/04 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Environmental Deficiencies
|
|
Deficiency
|
Make sure that staff members wash their hands when needed.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/02/04 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Environmental Deficiencies
|
|
Deficiency
|
Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection.
|
|
Level of Harm
|
Potential for minimal harm
|
|
|
Date of Survey
|
2005/02/04 (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
|
|