ATHERTON HEALTHCARE CA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
12/22/2010	approved construction type or materials.	Pattern	Minimal harm or potential for actual harm
12/22/2010	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
12/22/2010	exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detectors.	Pattern	Minimal harm or potential for actual harm
12/22/2010	construction that can resist fire for one hour or an approved fire extinguishing system.	Isolated	Minimal harm or potential for actual harm
12/22/2010	protected exits that allow the resident to escape the building.	Pattern	Minimal harm or potential for actual harm
12/22/2010	record of quarterly fire drills for each shift under varying conditions.	Isolated	Minimal harm or potential for actual harm
12/22/2010	portable fire extinguishers.	Isolated	Minimal harm or potential for actual harm
12/22/2010	properly constructed linen or trash chutes.	Pattern	Minimal harm or potential for actual harm
12/22/2010	restrictions on the use of highly flammable materials.	Isolated	Minimal harm or potential for actual harm
12/22/2010	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
12/20/2010	Let residents give themselves their drugs if they are able.	Isolated	Minimal harm or potential for actual harm
12/20/2010	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
12/20/2010	Keep safe, clean and homelike surroundings.	Isolated	Minimal harm or potential for actual harm
12/20/2010	Keep adequate and comfortable lighting in all areas.	Isolated	Minimal harm or potential for actual harm
12/20/2010	Keep sound levels comfortable.	Isolated	Minimal harm or potential for actual harm
12/20/2010	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
12/20/2010	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
12/20/2010	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
12/20/2010	Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion.	Isolated	Minimal harm or potential for actual harm
12/20/2010	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
12/20/2010	Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	Isolated	Minimal harm or potential for actual harm
12/20/2010	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
12/20/2010	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
12/20/2010	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
12/20/2010	Keep all essential equipment working safely.	Isolated	Minimal harm or potential for actual harm
12/20/2010	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Isolated	Minimal harm or potential for actual harm
12/20/2010	Put firmly secured handrails on each side of hallways.	Pattern	Minimal harm or potential for actual harm
12/20/2010	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
12/16/2009	Honor all of the resident's rights as a resident of the nursing home and as a citizen or resident of the United States.	Isolated	Minimal harm or potential for actual harm
12/16/2009	Allow residents to easily see the results of the nursing home's most recent survey.	Pattern	Potential for minimal harm
12/16/2009	Protect each resident from all abuse, physical punishment, and being separated from others.	Isolated	Minimal harm or potential for actual harm
12/16/2009	Provide services to meet the needs and preferences of each resident.	Pattern	Minimal harm or potential for actual harm
12/16/2009	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
12/16/2009	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
12/16/2009	Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	Pattern	Potential for minimal harm
12/16/2009	Provide food in a way that meets a resident's needs.	Isolated	Minimal harm or potential for actual harm
12/16/2009	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
12/16/2009	Make sure that a working call system is available in each resident's room or bathroom and bathing area.	Isolated	Minimal harm or potential for actual harm
12/16/2009	Put firmly secured handrails on each side of hallways.	Isolated	Minimal harm or potential for actual harm
12/16/2009	record of quarterly fire drills for each shift under varying conditions.	Isolated	Minimal harm or potential for actual harm
12/16/2009	an approved installation, maintenance and testing program for fire alarm systems.	Widespread	Minimal harm or potential for actual harm
12/16/2009	automatic sprinkler systems that have been maintained in working order.	Widespread	Minimal harm or potential for actual harm
12/16/2009	properly constructed linen or trash chutes.	Pattern	Minimal harm or potential for actual harm
12/16/2009	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
01/13/2009	an approved installation, maintenance and testing program for fire alarm systems.	Isolated	Minimal harm or potential for actual harm
01/13/2009	an automatic smoke detection system in all hallways.	Widespread	Minimal harm or potential for actual harm
01/13/2009	properly maintained smoke detectors.	Widespread	Minimal harm or potential for actual harm
01/13/2009	restrictions on the use of highly flammable materials.	Isolated	Minimal harm or potential for actual harm
01/13/2009	proper power supply for life support equipment.	Isolated	Minimal harm or potential for actual harm
01/09/2009	Keep safe, clean and homelike surroundings.	Isolated	Minimal harm or potential for actual harm
01/09/2009	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
01/09/2009	Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	Pattern	Minimal harm or potential for actual harm
01/09/2009	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	Minimal harm or potential for actual harm
01/09/2009	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
01/09/2009	Have drugs and other similar products available, which are needed every day and in emergencies, and give them out properly.	Isolated	Minimal harm or potential for actual harm
01/09/2009	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
01/09/2009	Put firmly secured handrails on each side of hallways.	Pattern	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