Cloverdale TraceHealthcareAnd Rehab

Total Number of Beds: 85	Percent of Occupied Beds: 86%
Total Number of Residents: 73	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 06/13/2002

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.39

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.99

Number of CNA Hours per Nursing Home Resident per Day: 1.75

Number of Staff Hours per Nursing Home Resident per Day: 3.13

Nursing Home Resident Information**:

** Details Last Reported on: 6/13/2002

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2000-06-07	2000-06-20	Mistreatment Deficiencies	Protect each resident from all abuse, physical punishment, and being separated from others.	Pattern	Immediate jeopardy to resident health or safety
2000-06-07	2000-06-23	Mistreatment Deficiencies	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.	Pattern	Minimal harm or potential for actual harm
2000-06-07	2000-06-20	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Immediate jeopardy to resident health or safety
2000-06-07	2000-06-23	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Isolated	Actual harm
2000-06-07	2000-06-23	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
2000-06-07	2000-06-23	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Immediate jeopardy to resident health or safety
2000-06-07	2000-06-20	Quality Care Deficiencies	Give the right treatment and services to residents who have mental or social problems adjusting.	Pattern	Immediate jeopardy to resident health or safety
2000-06-07	2000-06-23	Pharmacy Service Deficiencies	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
2000-06-07	2000-06-23	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2000-06-07	2000-06-23	Environmental Deficiencies	Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection.	Isolated	Minimal harm or potential for actual harm
2000-06-07	2000-06-20	Administration Deficiencies	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
2001-07-12	2001-07-24	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2001-07-12	2001-07-24	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Pattern	Minimal harm or potential for actual harm
2001-07-12	2001-07-24	Resident Assessment Deficiencies	Provide a final summary of the resident's health status and a summary of the resident's stay, when the resident is ready to leave the nursing home.	Widespread	Potential for minimal harm
2001-07-12	2001-07-24	Quality Care Deficiencies	Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.	Isolated	Minimal harm or potential for actual harm
2001-07-12	2001-07-24	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2001-07-12	2001-07-24	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Minimal harm or potential for actual harm
2002-06-13	2002-07-03	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Pattern	Minimal harm or potential for actual harm
2002-06-13	2002-07-03	Mistreatment Deficiencies	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
2002-06-13	2002-07-03	Resident Assessment Deficiencies	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
2002-06-13	2002-07-03	Resident Assessment Deficiencies	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
2002-06-13	2002-07-03	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
2002-06-13	2002-07-03	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2002-06-13	2002-07-03	Quality Care Deficiencies	Make sure that residents with loss of bladder control receive treatment or service to prevent infections and help get normal bladder control.	Isolated	Actual harm
2002-06-13	2002-06-13	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Immediate jeopardy to resident health or safety
2002-06-13	2002-07-11	Quality Care Deficiencies	Give each resident enough fluids to keep them healthy and prevent dehydration.	Isolated	Actual harm
2002-06-13	2002-06-24	Pharmacy Service Deficiencies	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	Immediate jeopardy to resident health or safety
2002-06-13	2002-07-03	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2002-06-13	2002-06-24	Pharmacy Service Deficiencies	Make sure that the pharmacist reports anything unusual to the doctor on duty and the director of nursing.	Isolated	Immediate jeopardy to resident health or safety
2002-06-13	2002-07-03	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2002-06-13	2002-06-24	Administration Deficiencies	Give or get lab tests to meet the needs of residents.	Isolated	Immediate jeopardy to resident health or safety

*** All violations listed are based on federal government records.