Pacific Hospital of Long Beach

Total Number of Beds: 27	Percent of Occupied Beds: 67%
Total Number of Residents: 18	Located Within a Hospital: Yes
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 08/30/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day:

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

Number of CNA Hours per Nursing Home Resident per Day:

Number of Staff Hours per Nursing Home Resident per Day:

Nursing Home Resident Information**:

** Details Last Reported on: 8/30/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-05-22	2001-07-01	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Potential for minimal harm
2001-05-22	2001-07-01	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2001-05-22	2001-07-01	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Pattern	Potential for minimal harm
2001-05-22	2001-07-01	Quality Care Deficiencies	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.	Pattern	Potential for minimal harm
2001-05-22	2001-07-01	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Pattern	Potential for minimal harm
2002-08-07	2002-09-16	Resident Rights Deficiencies	Tell the resident completely about his or her health status.	Pattern	Potential for minimal harm
2002-08-07	2002-09-16	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Potential for minimal harm
2002-08-07	2002-09-16	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Potential for minimal harm
2002-08-07	2002-09-16	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2002-08-07	2002-09-16	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
2002-08-07	2002-09-16	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2002-08-07	2002-09-16	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
2002-08-07	2002-09-16	Quality Care Deficiencies	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.	Pattern	Minimal harm or potential for actual harm
2002-08-07	2002-09-16	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2002-08-07	2002-09-16	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2002-08-07	2002-09-16	Environmental Deficiencies	Keep all essential equipment working safely.	Pattern	Potential for minimal harm
2002-08-07	2002-09-16	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Widespread	Potential for minimal harm
2002-08-07	2002-09-16	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
2003-08-30	2003-09-15	Resident Assessment Deficiencies	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Pattern	Potential for minimal harm
2003-08-30	2003-09-15	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Pattern	Potential for minimal harm
2003-08-30	2003-09-15	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Pattern	Potential for minimal harm
2003-08-30	2003-09-15	Quality Care Deficiencies	Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion.	Pattern	Potential for minimal harm
2003-08-30	2003-09-15	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2003-08-30	2003-09-15	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
2003-08-30	2003-09-15	Administration Deficiencies	Have a detailed, written plan for disasters and emergencies.	Pattern	Potential for minimal harm

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