Citrus Valley Mc Qv Dp Skilled Nursing Facility

Total Number of Beds: 23	Percent of Occupied Beds: 87%
Total Number of Residents: 20	Located Within a Hospital: Yes
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 09/09/2003

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**:

** Details Last Reported on: 9/9/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-07-19	2001-09-04	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2001-07-19	2001-09-04	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Potential for minimal harm
2001-07-19	2001-09-04	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
2001-07-19	2001-09-04	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Potential for minimal harm
2001-07-19	2001-09-04	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2001-07-19	2001-09-04	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
2001-07-19	2001-09-04	Resident Assessment Deficiencies	Develop a plan with the resident and family for the resident's care after leaving the nursing home.	Pattern	Potential for minimal harm
2001-07-19	2001-09-04	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
2001-07-19	2001-09-04	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2001-07-19	2001-09-04	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Isolated	Minimal harm or potential for actual harm
2001-07-19	2001-09-04	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
2002-09-12	2002-10-24	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Pattern	Potential for minimal harm
2002-09-12	2002-10-24	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
2002-09-12	2002-10-24	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2002-09-12	2002-10-24	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2002-09-12	2002-10-24	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
2002-09-12	2002-10-24	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Potential for minimal harm
2002-09-12	2002-10-24	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2002-09-12	2002-10-24	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Pattern	Potential for minimal harm
2002-09-12	2002-10-24	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2002-09-12	2002-10-24	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Isolated	Minimal harm or potential for actual harm
2002-09-12	2002-10-24	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
2003-09-09	2003-09-26	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Pattern	Potential for minimal harm
2003-09-09	2003-09-26	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
2003-09-09	2003-09-26	Quality Care Deficiencies	Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.	Pattern	Potential for minimal harm
2003-09-09	2003-09-26	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm

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