Northern California Rehab Hospital

Total Number of Beds: 50	Percent of Occupied Beds: 92%
Total Number of Residents: 46	Located Within a Hospital: Yes
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 Only
* Details Last Reported on: 11/14/2003

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 Short-Stay Residents With Pressure Sores: 31%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 62%
Percent of Short-Stay Residents With Delirium: 0%
** Details Last Reported on: 11/14/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-08-09	2001-10-19	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.	Pattern	Potential for minimal harm
2001-08-09	2001-10-19	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Pattern	Potential for minimal harm
2001-08-09	2001-10-22	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Pattern	Potential for minimal harm
2001-08-09	2001-10-01	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
2001-08-09	2001-10-16	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
2001-08-09	2001-10-22	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
2001-08-09	2001-10-01	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Pattern	Potential for minimal harm
2001-08-09	2001-08-15	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2001-08-09	2001-08-15	Environmental Deficiencies	Get rid of garbage properly.	Pattern	Potential for minimal harm
2001-08-09	2001-10-10	Pharmacy Service Deficiencies	Make sure that the pharmacist reports anything unusual to the doctor on duty and the director of nursing.	Pattern	Potential for minimal harm
2001-08-09	2001-10-10	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
2002-10-18	2002-11-22	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
2002-10-18	2002-11-22	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
2002-10-18	2002-11-22	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
2002-10-18	2002-11-22	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.	Isolated	Minimal harm or potential for actual harm
2002-10-18	2002-11-22	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
2002-10-18	2002-11-22	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Isolated	Minimal harm or potential for actual harm
2002-10-18	2002-11-22	Pharmacy Service Deficiencies	Act when the pharmacist reports something unusual.	Pattern	Minimal harm or potential for actual harm
2002-10-18	2002-11-22	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Pattern	Potential for minimal harm
2002-10-18	2002-11-22	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
2003-11-14	2003-12-26	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
2003-11-14	2003-12-26	Resident Rights Deficiencies	Let residents give themselves their drugs if they are able.	Isolated	Minimal harm or potential for actual harm
2003-11-14	2003-12-26	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Isolated	Minimal harm or potential for actual harm
2003-11-14	2003-12-26	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.	Pattern	Minimal harm or potential for actual harm
2003-11-14	2003-12-26	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2003-11-14	2003-12-26	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
2003-11-14	2003-12-26	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Pattern	Potential for minimal harm
2003-11-14	2003-12-26	Nutrition and Dietary Deficiencies	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Potential for minimal harm
2003-11-14	2003-12-26	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
2003-11-14	2003-12-26	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Isolated	Minimal harm or potential for actual harm
2003-11-14	2003-12-26	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2003-11-14	2003-12-26	Environmental Deficiencies	Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection.	Widespread	Potential for minimal harm
2003-11-14	2003-12-26	Environmental Deficiencies	Keep all essential equipment working safely.	Isolated	Minimal harm or potential for actual harm
2003-11-14	2003-12-26	Administration Deficiencies	Give or get lab tests to meet the needs of residents.	Isolated	Minimal harm or potential for actual harm
2003-11-14	2003-12-26	Administration Deficiencies	Set up or keep a group of people to review and ensure quality.	Widespread	Potential for minimal harm

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