Beverly Manor Petaluma

Total Number of Beds: 99	Percent of Occupied Beds: 69%
Total Number of Residents: 68	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 06/12/2003

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**:

Percent of High-Risk Residents Who Have Pressure Sores: 12%
Percent of Residents Who Have Moderate to Severe Pain: 4%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 15%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 0%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 16%
Percent of Residents Who are More Depressed or Anxious: 8%
Percent of Residents Who Were Physically Restrained: 10%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 76%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 3%
Percent of Residents With a Urinary Tract Infection: 8%
** Details Last Reported on: 6/12/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-02-07	2001-05-10	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.	Isolated	Minimal harm or potential for actual harm
2001-02-07	2001-05-10	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Isolated	Minimal harm or potential for actual harm
2001-02-07	2001-05-10	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2001-02-07	2001-05-10	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Isolated	Minimal harm or potential for actual harm
2001-02-07	2001-05-10	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Isolated	Minimal harm or potential for actual harm
2001-02-07	2001-05-10	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Minimal harm or potential for actual harm
2001-02-07	2001-05-10	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2001-02-07	2001-05-10	Quality Care Deficiencies	Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.	Isolated	Minimal harm or potential for actual harm
2001-02-07	2001-05-10	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
2001-02-07	2001-05-10	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
2001-02-07	2001-05-10	Pharmacy Service Deficiencies	Gradually lower the dose of residents' antipsychotic drugs, unless this causes negative medical effects.	Isolated	Minimal harm or potential for actual harm
2001-02-07	2001-05-10	Quality Care Deficiencies	Have enough nurses to care for every resident in a way that maximizes the resident's well being.	Isolated	Minimal harm or potential for actual harm
2001-02-07	2001-05-10	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2001-02-07	2001-05-10	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
2001-02-07	2001-05-10	Administration Deficiencies	1) Set up a group that is legally responsible for writing and setting up policies for leading and running the nursing home; or 2) hire a properly licensed administrator.	Isolated	Minimal harm or potential for actual harm
2001-02-07	2001-05-10	Administration Deficiencies	Choose a doctor to be the medical director.	Isolated	Minimal harm or potential for actual harm
2001-02-07	2001-05-10	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
2002-03-21	2002-05-12	Resident Rights Deficiencies	Let residents give themselves their drugs if they are able.	Isolated	Minimal harm or potential for actual harm
2002-03-21	2002-05-12	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
2002-03-21	2002-05-12	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Widespread	Potential for minimal harm
2002-03-21	2002-05-12	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
2002-03-21	2002-05-12	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
2002-03-21	2002-05-12	Environmental Deficiencies	Keep adequate and comfortable lighting in all areas.	Isolated	Minimal harm or potential for actual harm
2002-03-21	2002-05-12	Environmental Deficiencies	Keep sound levels comfortable.	Pattern	Minimal harm or potential for actual harm
2002-03-21	2002-05-12	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	Minimal harm or potential for actual harm
2002-03-21	2002-05-12	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
2002-03-21	2002-05-12	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
2002-03-21	2002-05-12	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	Minimal harm or potential for actual harm
2002-03-21	2002-05-12	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2002-03-21	2002-05-12	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
2002-03-21	2002-05-12	Quality Care Deficiencies	Give each resident enough fluids to keep them healthy and prevent dehydration.	Isolated	Minimal harm or potential for actual harm
2002-03-21	2002-05-12	Quality Care Deficiencies	Have enough nurses to care for every resident in a way that maximizes the resident's well being.	Isolated	Minimal harm or potential for actual harm
2002-03-21	2002-05-12	Nutrition and Dietary Deficiencies	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Potential for minimal harm
2002-03-21	2002-05-12	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
2002-03-21	2002-05-12	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2003-06-12	2003-07-10	Resident Rights Deficiencies	Properly hold, secure and manage each resident's personal money which is deposited with the nursing home.	Pattern	Potential for minimal harm
2003-06-12	2003-07-10	Resident Rights Deficiencies	Try to resolve each resident's complaints quickly.	Isolated	Minimal harm or potential for actual harm
2003-06-12	2003-07-10	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2003-06-12	2003-07-10	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
2003-06-12	2003-07-10	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Minimal harm or potential for actual harm
2003-06-12	2003-07-10	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
2003-06-12	2003-07-10	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
2003-06-12	2003-07-10	Resident Assessment Deficiencies	Develop a plan with the resident and family for the resident's care after leaving the nursing home.	Isolated	Minimal harm or potential for actual harm
2003-06-12	2003-07-10	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
2003-06-12	2003-07-10	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.	Isolated	Minimal harm or potential for actual harm
2003-06-12	2003-07-10	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2003-06-12	2003-07-10	Quality Care Deficiencies	Give or get dental care for each resident.	Pattern	Minimal harm or potential for actual harm
2003-06-12	2003-07-10	Pharmacy Service Deficiencies	Act when the pharmacist reports something unusual.	Pattern	Minimal harm or potential for actual harm
2003-06-12	2003-07-10	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2003-06-12	2003-07-10	Environmental Deficiencies	Keep all essential equipment working safely.	Pattern	Minimal harm or potential for actual harm
2003-06-12	2003-07-10	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
2003-06-12	2003-07-10	Administration Deficiencies	Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person.	Pattern	Potential for minimal harm
2003-06-12	2003-07-10	Administration Deficiencies	Train all employees on what to do in an emergency.	Pattern	Potential for minimal harm

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