ARDEN REHAB & HEALTH CENTER CA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
01/25/2010	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
01/25/2010	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
01/25/2010	smoke barrier doors that can resist smoke for at least 20 minutes.	Pattern	Minimal harm or potential for actual harm
01/25/2010	emergency lighting that can last at least 1 1/2 hours.	Isolated	Minimal harm or potential for actual harm
01/25/2010	automatic sprinkler systems that have been maintained in working order.	Isolated	Minimal harm or potential for actual harm
01/25/2010	restrictions on the use of highly flammable materials.	Widespread	Potential for minimal harm
01/25/2010	proper medical gas storage and administration areas.	Pattern	Minimal harm or potential for actual harm
01/25/2010	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
01/25/2010	properly installed hallway dispensers for alcohol-based hand rub.	Pattern	Minimal harm or potential for actual harm
01/08/2010	Tell the resident completely about his or her health status.	Isolated	Minimal harm or potential for actual harm
01/08/2010	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
01/08/2010	Keep safe, clean and homelike surroundings.	Pattern	Potential for minimal harm
01/08/2010	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
01/08/2010	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
01/08/2010	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
01/08/2010	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
01/08/2010	Make sure that each resident who enters the nursing home without a catheter is not given a catheter, unless it is necessary.	Isolated	Minimal harm or potential for actual harm
01/08/2010	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
01/08/2010	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
01/08/2010	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Isolated	Minimal harm or potential for actual harm
01/08/2010	Give or get special rehabilitation if in the patient's plan of care.	Isolated	Minimal harm or potential for actual harm
01/08/2010	Have drugs and other similar products available, which are needed every day and in emergencies, and give them out properly.	Pattern	Minimal harm or potential for actual harm
01/08/2010	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Isolated	Minimal harm or potential for actual harm
01/08/2010	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
01/08/2010	Provide rooms that are big enough for each resident.	Widespread	Potential for minimal harm
01/08/2010	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
01/27/2009	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
01/27/2009	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
01/27/2009	a fire alarm system that can be heard throughout the facility.	Isolated	Minimal harm or potential for actual harm
01/27/2009	properly protected cooking facilities.	Widespread	Potential for minimal harm
01/27/2009	proper medical gas storage and administration areas.	Pattern	Minimal harm or potential for actual harm
01/21/2009	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
01/21/2009	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
01/21/2009	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
01/21/2009	Provide activities to meet the needs of each resident.	Isolated	Minimal harm or potential for actual harm
01/21/2009	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Isolated	Minimal harm or potential for actual harm
01/21/2009	Assess the resident when the resident enters the nursing home, in a timely manner.	Isolated	Minimal harm or potential for actual harm
01/21/2009	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
01/21/2009	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
01/21/2009	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
01/21/2009	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
01/21/2009	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
01/21/2009	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
01/21/2009	Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion.	Pattern	Minimal harm or potential for actual harm
01/21/2009	Give the right treatment and services to residents who have mental or social problems adjusting.	Isolated	Minimal harm or potential for actual harm
01/21/2009	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
01/21/2009	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.	Pattern	Minimal harm or potential for actual harm
01/21/2009	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
01/21/2009	Make sure that residents are safe from serious medication errors.	Pattern	Immediate jeopardy to resident health or safety
01/21/2009	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Potential for minimal harm
01/21/2009	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
01/21/2009	Have drugs and other similar products available, which are needed every day and in emergencies, and give them out properly.	Pattern	Immediate jeopardy to resident health or safety
01/21/2009	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Pattern	Immediate jeopardy to resident health or safety
01/21/2009	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
01/21/2009	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
01/21/2009	Provide rooms that are big enough for each resident.	Widespread	Potential for minimal harm
01/21/2009	Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person.	Pattern	Potential for minimal harm
01/21/2009	Have a detailed, written plan for disasters and emergencies.	Pattern	Potential for minimal harm
12/12/2007	approved construction type or materials.	Widespread	Potential for minimal harm
12/12/2007	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
12/12/2007	properly working alarms on sprinkler valves.	Isolated	Minimal harm or potential for actual harm
12/12/2007	fire safety features required by current fire safety codes.	Pattern	Potential for minimal harm
12/12/2007	properly installed electrical wiring and equipment.	Pattern	Potential for minimal harm
12/07/2007	Provide enough notice before discharging or transferring a resident.	Isolated	Minimal harm or potential for actual harm
12/07/2007	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
12/07/2007	Do an assessment of the resident every year.	Isolated	Minimal harm or potential for actual harm
12/07/2007	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
12/07/2007	Keep assessments completed in the preceding 15 months in the resident's active record.	Isolated	Minimal harm or potential for actual harm
12/07/2007	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
12/07/2007	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
12/07/2007	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.	Pattern	Minimal harm or potential for actual harm
12/07/2007	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
12/07/2007	Make sure that residents are safe from serious medication errors.	Pattern	Minimal harm or potential for actual harm
12/07/2007	Develop/implement required procedures for the administration of immunizations.	Isolated	Minimal harm or potential for actual harm
12/07/2007	Hire enough skilled workers to carry out dietary service.	Widespread	Minimal harm or potential for actual harm
12/07/2007	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Widespread	Minimal harm or potential for actual harm
12/07/2007	Make sure that the attending doctor orders special diets.	Isolated	Minimal harm or potential for actual harm
12/07/2007	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
12/07/2007	Give or get special rehabilitation if in the patient's plan of care.	Isolated	Minimal harm or potential for actual harm
12/07/2007	Have drugs and other similar products available, which are needed every day and in emergencies, and give them out properly.	Pattern	Minimal harm or potential for actual harm
12/07/2007	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Pattern	Minimal harm or potential for actual harm
12/07/2007	Properly mark drugs and other similar products.	Pattern	Minimal harm or potential for actual harm
12/07/2007	Provide rooms that are big enough for each resident.	Pattern	Potential for minimal harm
12/07/2007	Keep complete, dated lab records in the resident's file.	Isolated	Minimal harm or potential for actual harm
12/07/2007	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm

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Where does this data come from?

The data on this website describes nursing home characteristics, quality measures, inspection results, and nursing staff information.

The data come from 2 sources:

1. Centers for Medicare & Medicaid Services (CMS) have an Online Survey, Certification, and Reporting (OSCAR) database - Includes the nursing home characteristics and health deficiencies issued during the three most recent state inspections and recent complaint investigations.

   The survey inspection results are collected by the state survey agencies, who perform onsite visits to nursing homes . The inspections occur at least once during a 15-month period, or any time in between as a result of a complaint received by the state. The inspections ensure that the nursing home residents receive quality care and services in a safe and comfortable environment in accordance with rules established by CMS. Complaints may be reported and inspected during the year (outside of the 9-15 month survey cycle). Inspections about a complaint that result in the citation of a health deficiency are reported to CMS and included in this website. Sometimes the inspection finds a problem that the nursing home identified and corrected before the inspection occurred. The fact and the nature of these prior problems (deficiencies) may be included in this website.

   The information on the nursing homes' characteristics derived from OSCAR are prepared by each nursing home at the beginning of the regular State inspection. This information is reported by the nursing homes themselves. It is reviewed by nursing home inspectors, but not formally audited to ensure data accuracy. In addition, this information changes frequently as residents are discharged and admitted, or resident conditions change.

2. National database known as the Minimum Data Set (MDS) Repository

   The data for the quality measures come from the MDS Repository. The MDS is collected on regular intervals for every resident in a Medicare or Medicaid certified nursing home. Information is collected on the resident's health, physical functioning, mental status, and general well-being. These data are used by the nursing home to access the needs and develop a plan of care unique to each resident.

   Regulations require that a MDS assessment be performed at admission, quarterly, annually, and whenever the resident experiences a significant change in status. For residents in a Medicare Part A stay, the MDS is also used to determine the Medicare reimbursement rate. These assessments are performed on the 5th, 14th, 30th, 60th and 90th day of admission.

   All of this data is reported by the nursing homes themselves. It is reviewed by nursing home inspectors, but not formally audited to ensure that it is accurate. Every attempt is made to assure the accuracy and timeliness of this information. However, this information changes frequently as residents are discharged and admitted, or resident conditions change. We advise interpreting this information cautiously and supplementing it with information from the Ombudsman's office, the State Survey Agency, or other sources.

   Some MDS items used to calculate the quality measures consider the resident's condition during previous days prior to the assessment date. The following table provides these "observation" or "look back" time frames.

Signs of Nursing Home Abuse:

• Unexplained injuries or bruises
• Over or under medication
• Visible cuts, bruises, or welts
• Rapid weight loss or weight gain
• Dehydration, malnutrition, and bedsores
• Unsanitary living conditions
• Infections
• Broken bones
• Sudden death