Santa Rosa Health & Rehabilitation Center

Total Number of Beds: 120	Percent of Occupied Beds: 80%
Total Number of Residents: 96	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 12/04/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.64

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.93

Number of CNA Hours per Nursing Home Resident per Day: 2.8

Number of Staff Hours per Nursing Home Resident per Day: 4.37

Nursing Home Resident Information**:

Percent of Low-Risk Residents Who Have Pressure Sores: 0%
Percent of Short-Stay Residents With Pressure Sores: 28%
Percent of High-Risk Residents Who Have Pressure Sores: 10%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 60%
Percent of Residents Who Have Moderate to Severe Pain: 13%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 9%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 11%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 9%
Percent of Residents Who are More Depressed or Anxious: 12%
Percent of Short-Stay Residents With Delirium: 4%
Percent of Residents Who Were Physically Restrained: 16%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 72%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 4%
Percent of Residents With a Urinary Tract Infection: 9%
** Details Last Reported on: 12/4/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-12-13	2002-01-15	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2001-12-13	2002-01-15	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Minimal harm or potential for actual harm
2001-12-13	2002-01-15	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
2001-12-13	2002-01-15	Resident Assessment Deficiencies	Do a new assessment after any major change in a resident's physical or mental health.	Isolated	Minimal harm or potential for actual harm
2001-12-13	2002-01-15	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.	Isolated	Minimal harm or potential for actual harm
2001-12-13	2002-01-15	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Isolated	Minimal harm or potential for actual harm
2001-12-13	2002-01-15	Quality Care Deficiencies	Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.	Pattern	Minimal harm or potential for actual harm
2001-12-13	2002-01-15	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2001-12-13	2002-01-15	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Actual harm
2001-12-13	2002-01-15	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
2001-12-13	2002-01-15	Pharmacy Service Deficiencies	Make sure that residents who have not taken antipsychotic drugs are not given these drugs, unless they are used to treat a problem that is diagnosed and noted in the medical record.	Isolated	Minimal harm or potential for actual harm
2001-12-13	2002-01-15	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
2001-12-13	2002-01-15	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2001-12-13	2002-01-15	Pharmacy Service Deficiencies	Make sure that the pharmacist reports anything unusual to the doctor on duty and the director of nursing.	Isolated	Minimal harm or potential for actual harm
2001-12-13	2002-01-15	Environmental Deficiencies	Have a program to keep infection from spreading.	Widespread	Minimal harm or potential for actual harm
2001-12-13	2002-01-15	Administration Deficiencies	Quickly tell the resident's doctor the results of lab tests.	Isolated	Minimal harm or potential for actual harm
2002-09-18	2002-10-22	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Isolated	Minimal harm or potential for actual harm
2002-09-18	2002-10-22	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Isolated	Minimal harm or potential for actual harm
2002-09-18	2002-10-22	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.	Isolated	Minimal harm or potential for actual harm
2002-09-18	2002-10-22	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Minimal harm or potential for actual harm
2002-09-18	2002-10-22	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
2002-09-18	2002-10-22	Quality Care Deficiencies	Use a registered nurse at least 8 hours a day, 7 days a week.	Isolated	Minimal harm or potential for actual harm
2002-09-18	2002-10-22	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Pattern	Minimal harm or potential for actual harm
2002-09-18	2002-10-22	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2002-09-18	2002-10-22	Environmental Deficiencies	Keep a resident apart from the others if the resident has an infection that can spread.	Isolated	Minimal harm or potential for actual harm
2002-09-18	2002-10-22	Administration Deficiencies	1) Review the work of each nurse aide every year; or 2) give regular training for the nurse aides.	Isolated	Minimal harm or potential for actual harm
2003-12-04	2003-12-19	Resident Rights Deficiencies	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.	Isolated	Minimal harm or potential for actual harm
2003-12-04	2004-01-03	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2003-12-04	2004-01-03	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
2003-12-04	2003-12-19	Resident Assessment Deficiencies	Do a new assessment after any major change in a resident's physical or mental health.	Isolated	Minimal harm or potential for actual harm
2003-12-04	2003-12-10	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
2003-12-04	2003-12-18	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2003-12-04	2003-12-18	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
2003-12-04	2003-12-05	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Pattern	Minimal harm or potential for actual harm
2003-12-04	2003-12-18	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Pattern	Minimal harm or potential for actual harm
2003-12-04	2003-12-18	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
2003-12-04	2003-12-18	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
2003-12-04	2003-12-05	Environmental Deficiencies	Make sure that a working call system is available in each resident's room or bathroom and bathing area.	Widespread	Minimal harm or potential for actual harm
2003-12-04	2004-01-03	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Minimal harm or potential for actual harm

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