| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-02-13 |
2001-03-30 |
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 |
| 2001-02-13 |
2001-03-30 |
Mistreatment Deficiencies |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-02-13 |
2001-03-30 |
Mistreatment Deficiencies |
Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property. |
Pattern |
Potential for minimal harm |
| 2001-02-13 |
2001-03-30 |
Resident Rights Deficiencies |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Pattern |
Potential for minimal harm |
| 2001-02-13 |
2001-03-30 |
Environmental Deficiencies |
Keep safe, clean and homelike surroundings. |
Pattern |
Potential for minimal harm |
| 2001-02-13 |
2001-03-30 |
Resident Assessment Deficiencies |
Assess the resident when the resident enters the nursing home, in a timely manner. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-02-13 |
2001-03-30 |
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 |
Potential for minimal harm |
| 2001-02-13 |
2001-03-30 |
Quality Care Deficiencies |
Give each resident care and services to get or keep the highest quality of life possible. |
Pattern |
Minimal harm or potential for actual harm |
| 2001-02-13 |
2001-03-30 |
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 |
| 2001-02-13 |
2001-03-30 |
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. |
Pattern |
Potential for minimal harm |
| 2001-02-13 |
2001-03-30 |
Environmental Deficiencies |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-02-13 |
2001-03-30 |
Quality Care Deficiencies |
Make sure that each resident's nutritional needs were met. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-02-13 |
2001-03-30 |
Quality Care Deficiencies |
Give each resident a special diet to help when there is a nutritional problem. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-02-13 |
2001-03-30 |
Quality Care Deficiencies |
Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-02-13 |
2001-03-30 |
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 |
| 2001-02-13 |
2001-03-30 |
Nutrition and Dietary Deficiencies |
Hire enough skilled workers to carry out dietary service. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-02-13 |
2001-03-30 |
Nutrition and Dietary Deficiencies |
Make sure that residents are well nourished. |
Pattern |
Potential for minimal harm |
| 2001-02-13 |
2001-03-30 |
Nutrition and Dietary Deficiencies |
Offer other nutritional food to each resident who will not eat the food served. |
Pattern |
Potential for minimal harm |
| 2001-02-13 |
2001-03-30 |
Nutrition and Dietary Deficiencies |
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. |
Pattern |
Potential for minimal harm |
| 2001-02-13 |
2001-03-30 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Pattern |
Potential for minimal harm |
| 2001-02-13 |
2001-03-30 |
Pharmacy Service Deficiencies |
Provide drugs and related services needed by each resident. |
Pattern |
Potential for minimal harm |
| 2001-02-13 |
2001-03-30 |
Administration Deficiencies |
Hire nurse aides who have completed required training and shown that they are skilled. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-02-13 |
2001-03-30 |
Administration Deficiencies |
Quickly tell the resident's doctor the results of x-rays and other tests. |
Pattern |
Potential for minimal harm |
| 2001-02-13 |
2001-03-30 |
Administration Deficiencies |
Keep accurate and appropriate medical records. |
Pattern |
Potential for minimal harm |
| 2002-03-07 |
2002-04-03 |
Resident Rights Deficiencies |
Tell each resident who can get Medicaid benefits about 1) which items and services Medicaid covers and which the resident must pay for; or 2) how to apply for Medicaid, along with the names and addresses of State groups that can help. |
Pattern |
Potential for minimal harm |
| 2002-03-07 |
2002-03-29 |
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 |
| 2002-03-07 |
2002-03-22 |
Resident Rights Deficiencies |
Let residents give themselves their drugs if they are able. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-03-07 |
2002-03-30 |
Mistreatment Deficiencies |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-03-07 |
2002-03-26 |
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 |
| 2002-03-07 |
2002-03-29 |
Resident Assessment Deficiencies |
Assess the resident when the resident enters the nursing home, in a timely manner. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-03-07 |
2002-03-29 |
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 |
| 2002-03-07 |
2002-04-02 |
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 |
| 2002-03-07 |
2002-04-03 |
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. |
Pattern |
Potential for minimal harm |
| 2002-03-07 |
2002-03-08 |
Resident Assessment Deficiencies |
Keep assessments completed in the preceding 15 months in the resident's active record. |
Pattern |
Potential for minimal harm |
| 2002-03-07 |
2002-04-02 |
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 |
| 2002-03-07 |
2002-03-30 |
Quality Care Deficiencies |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-03-07 |
2002-04-04 |
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 |
| 2002-03-07 |
2002-04-03 |
Quality Care Deficiencies |
Make sure that each resident's nutritional needs were met. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-03-07 |
2002-04-01 |
Nutrition and Dietary Deficiencies |
Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-03-07 |
2002-04-03 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Pattern |
Potential for minimal harm |
| 2002-03-07 |
2002-04-01 |
Pharmacy Service Deficiencies |
Properly mark drugs and other similar products. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-03-07 |
2002-03-22 |
Pharmacy Service Deficiencies |
Keep drugs and other similar products locked safely and properly stored. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-03-07 |
2002-04-03 |
Administration Deficiencies |
Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person. |
Widespread |
Potential for minimal harm |
| 2003-02-25 |
2003-03-21 |
Environmental Deficiencies |
Keep adequate and comfortable lighting in all areas. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-02-25 |
2003-03-21 |
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 |
| 2003-02-25 |
2003-03-21 |
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 |
| 2003-02-25 |
2003-03-21 |
Quality Care Deficiencies |
Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-02-25 |
2003-03-21 |
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 |
| 2003-02-25 |
2003-03-21 |
Pharmacy Service Deficiencies |
Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-02-25 |
2003-03-21 |
Pharmacy Service Deficiencies |
Keep drugs and other similar products locked safely and properly stored. |
Pattern |
Potential for minimal harm |
| 2003-02-25 |
2003-03-21 |
Environmental Deficiencies |
Have a program to keep infection from spreading. |
Widespread |
Potential for minimal harm |
| 2003-02-25 |
2003-03-21 |
Environmental Deficiencies |
Be designed, built, equipped, or well kept to protect the health and safety of residents, workers, and the public. |
Isolated |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.