BEARTOOTH MANOR MT DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
09/16/2010	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Actual harm
09/16/2010	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
09/16/2010	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Pattern	Potential for minimal harm
09/16/2010	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Pattern	Minimal harm or potential for actual harm
09/16/2010	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
09/16/2010	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
09/16/2010	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
09/16/2010	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
09/16/2010	Make sure that the attending doctor orders special diets.	Isolated	Minimal harm or potential for actual harm
09/16/2010	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
09/16/2010	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Widespread	Minimal harm or potential for actual harm
09/16/2010	Be administered in a way that leads to the highest possible level of well being for each resident.	Pattern	Potential for minimal harm
09/16/2010	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
09/16/2010	Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person.	Pattern	Potential for minimal harm
09/14/2010	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
09/14/2010	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
09/14/2010	construction that can resist fire for one hour or an approved fire extinguishing system.	Pattern	Minimal harm or potential for actual harm
09/14/2010	exits that are accessible at all times.	Isolated	Minimal harm or potential for actual harm
09/14/2010	properly located and lighted "Exit" signs.	Isolated	Minimal harm or potential for actual harm
09/14/2010	properly maintained smoke detectors.	Widespread	Minimal harm or potential for actual harm
09/14/2010	automatic sprinkler systems that have been maintained in working order.	Pattern	Minimal harm or potential for actual harm
09/14/2010	portable fire extinguishers.	Isolated	Minimal harm or potential for actual harm
09/14/2010	restrictions on the use of flammable curtains.	Pattern	Minimal harm or potential for actual harm
09/14/2010	proper medical gas storage and administration areas.	Isolated	Minimal harm or potential for actual harm
09/14/2010	proper construction of ducts through walls designed to prevent smoke passage.	Pattern	Minimal harm or potential for actual harm
09/14/2010	properly installed electrical wiring and equipment.	Widespread	Minimal harm or potential for actual harm
09/03/2009	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	Minimal harm or potential for actual harm
09/03/2009	Use a registered nurse at least 8 hours a day, 7 days a week.	Widespread	Potential for minimal harm
09/03/2009	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
09/03/2009	Be administered in a way that leads to the highest possible level of well being for each resident.	Widespread	Potential for minimal harm
09/01/2009	approved construction type or materials.	Widespread	Minimal harm or potential for actual harm
09/01/2009	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
09/01/2009	corridors or aisles that are unobstructed and are at least 8 feet in width.	Widespread	Minimal harm or potential for actual harm
09/01/2009	emergency lighting that can last at least 1 1/2 hours.	Isolated	Minimal harm or potential for actual harm
09/01/2009	an approved automatic sprinkler system connected to the fire alarm system.	Isolated	Minimal harm or potential for actual harm
09/01/2009	portable fire extinguishers.	Isolated	Minimal harm or potential for actual harm
09/01/2009	exits that are free from obstructions and can be used at all times.	Isolated	Minimal harm or potential for actual harm
09/01/2009	restrictions on the use of flammable curtains.	Widespread	Minimal harm or potential for actual harm
09/01/2009	proper medical gas storage and administration areas.	Isolated	Minimal harm or potential for actual harm
09/01/2009	proper construction of ducts through walls designed to prevent smoke passage.	Widespread	Minimal harm or potential for actual harm
09/01/2009	fire safety features required by current fire safety codes.	Isolated	Minimal harm or potential for actual harm
09/01/2009	properly installed electrical wiring and equipment.	Widespread	Minimal harm or potential for actual harm
09/04/2008	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
09/04/2008	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
09/04/2008	Do a new assessment after any major change in a resident's physical or mental health.	Isolated	Minimal harm or potential for actual harm
09/04/2008	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Pattern	Potential for minimal harm
09/04/2008	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
09/04/2008	post nurse staffing information.	Widespread	Potential for minimal harm
09/04/2008	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
09/04/2008	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Isolated	Minimal harm or potential for actual harm
09/04/2008	Have enough backup water supply for important areas of the nursing home.	Widespread	Minimal harm or potential for actual harm
09/04/2008	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
09/03/2008	approved construction type or materials.	Pattern	Minimal harm or potential for actual harm
09/03/2008	corridor and hallway doors that block smoke.	Pattern	Potential for minimal harm
09/03/2008	walls or barriers that prevent smoke from passing through and would resist fire for at least one hour.	Pattern	Minimal harm or potential for actual harm
09/03/2008	construction that can resist fire for one hour or an approved fire extinguishing system.	Pattern	Minimal harm or potential for actual harm
09/03/2008	emergency lighting that can last at least 1 1/2 hours.	Widespread	Potential for minimal harm
09/03/2008	record of quarterly fire drills for each shift under varying conditions.	Pattern	Minimal harm or potential for actual harm
09/03/2008	an approved installation, maintenance and testing program for fire alarm systems.	Widespread	Potential for minimal harm
09/03/2008	an approved automatic sprinkler system connected to the fire alarm system.	Pattern	Minimal harm or potential for actual harm
09/03/2008	automatic sprinkler systems that have been maintained in working order.	Pattern	Minimal harm or potential for actual harm
09/03/2008	portable fire extinguishers.	Pattern	Potential for minimal harm
09/03/2008	exits that are free from obstructions and can be used at all times.	Pattern	Potential for minimal harm
09/03/2008	restrictions on the use of flammable curtains.	Pattern	Potential for minimal harm
09/03/2008	proper medical gas storage and administration areas.	Pattern	Minimal harm or potential for actual harm
09/03/2008	fire safety features required by current fire safety codes.	Pattern	Minimal harm or potential for actual harm
09/03/2008	properly installed electrical wiring and equipment.	Pattern	Potential for minimal harm
09/03/2008	back-up procedures in place for a faulty automatic sprinkler system.	Widespread	Potential for minimal harm
09/03/2008	an approved back-up procedure for a faulty fire alarm system.	Widespread	Potential for minimal 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