Evergreen Healthcare Centers of Vallejo - Heartwood

Total Number of Beds: 60	Percent of Occupied Beds: 93%
Total Number of Residents: 56	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: 11/06/2003

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 Residents Who Have Moderate to Severe Pain: 2%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 13%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 5%
Percent of Residents Who are More Depressed or Anxious: 7%
Percent of Residents Who Were Physically Restrained: 13%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 82%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 5%
Percent of Residents With a Urinary Tract Infection: 11%
** Details Last Reported on: 11/6/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-11-08	2001-12-20	Resident Rights Deficiencies	Provide written records when a resident is transferred or discharged.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-12-20	Mistreatment Deficiencies	Protect each resident from all abuse, physical punishment, and being separated from others.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-12-20	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
2001-11-08	2001-12-20	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-12-20	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-12-20	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2001-11-08	2001-12-20	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-12-20	Environmental Deficiencies	Put firmly secured handrails on each side of hallways.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-12-20	Administration Deficiencies	Choose a doctor to be the medical director.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-12-20	Administration Deficiencies	Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-12-20	Administration Deficiencies	Set up or keep a group of people to review and ensure quality.	Isolated	Minimal harm or potential for actual harm
2002-11-07	2002-12-19	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
2002-11-07	2002-12-19	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
2002-11-07	2002-12-19	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2002-11-07	2002-12-19	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
2002-11-07	2002-12-19	Environmental Deficiencies	Have a program to keep infection from spreading.	Widespread	Potential for minimal harm
2002-11-07	2002-12-19	Environmental Deficiencies	Keep all essential equipment working safely.	Widespread	Potential for minimal harm
2002-11-07	2002-12-19	Environmental Deficiencies	Have enough backup water supply for important areas of the nursing home.	Widespread	Potential for minimal harm
2003-11-06	2003-12-09	Resident Rights Deficiencies	Give the resident's legal representative the same rights as the resident.	Isolated	Minimal harm or potential for actual harm
2003-11-06	2003-12-09	Resident Rights Deficiencies	Tell the resident or the resident's representative in writing how long the nursing home will hold the resident's bed when the resident temporarily leaves the facility.	Isolated	Minimal harm or potential for actual harm
2003-11-06	2003-12-09	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2003-11-06	2003-12-09	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
2003-11-06	2003-12-09	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Pattern	Minimal harm or potential for actual harm
2003-11-06	2003-12-09	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Isolated	Minimal harm or potential for actual harm
2003-11-06	2003-12-09	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
2003-11-06	2003-12-09	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
2003-11-06	2003-12-09	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
2003-11-06	2003-12-09	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
2003-11-06	2003-12-09	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2003-11-06	2003-12-09	Nutrition and Dietary Deficiencies	Hire enough skilled workers to carry out dietary service.	Pattern	Minimal harm or potential for actual harm
2003-11-06	2003-12-09	Nutrition and Dietary Deficiencies	Provide special eating equipment and utensils for each resident who needs them.	Isolated	Minimal harm or potential for actual harm
2003-11-06	2003-12-09	Administration Deficiencies	Follow all laws and professional standards.	Widespread	Potential for minimal harm

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