BRIDGEWOOD HEALTH CARE CENTER MO DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
05/12/2010	Properly hold, secure and manage each resident's personal money which is deposited with the nursing home.	Pattern	Minimal harm or potential for actual harm
05/12/2010	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
05/12/2010	Electronically record and report resident status assessments in a timely manner as required in order to monitor resident health and progress.	Pattern	Potential for minimal harm
05/12/2010	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
05/12/2010	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
05/12/2010	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
05/12/2010	Develop/implement required procedures for the administration of immunizations.	Isolated	Minimal harm or potential for actual harm
05/12/2010	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
05/12/2010	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Potential for minimal harm
05/12/2010	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
05/12/2010	proper facilities for the use and storage of combustible liquids.	Pattern	Minimal harm or potential for actual harm
05/12/2010	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
06/09/2009	Have a private telephone available for use.	Pattern	Minimal harm or potential for actual harm
06/09/2009	Make sure each resident has the right to choose activities, schedules and health care according to his or her interests, assessment, and plan of care.	Isolated	Minimal harm or potential for actual harm
06/09/2009	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Pattern	Minimal harm or potential for actual harm
06/09/2009	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
06/09/2009	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
06/09/2009	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
06/09/2009	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
06/09/2009	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
06/09/2009	Screen residents when they are first admitted to send them to an area with special care for people with developmental disabilities or mental illness, if needed.	Isolated	Minimal harm or potential for actual harm
06/09/2009	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
06/09/2009	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
06/09/2009	Give the right treatment and services to residents who have mental or social problems adjusting.	Pattern	Immediate jeopardy to resident health or safety
06/09/2009	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
06/09/2009	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
06/09/2009	Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing.	Isolated	Minimal harm or potential for actual harm
06/09/2009	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
06/09/2009	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Widespread	Minimal harm or potential for actual harm
06/09/2009	Have enough outside airflow.	Pattern	Minimal harm or potential for actual harm
06/09/2009	Choose a doctor to be the medical director.	Pattern	Minimal harm or potential for actual harm
06/09/2009	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
06/09/2009	approved construction type or materials.	Pattern	Minimal harm or potential for actual harm
06/09/2009	signs that state that exit doors are to be kept closed.	Isolated	Minimal harm or potential for actual harm
06/09/2009	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
06/09/2009	smoke barrier doors that can resist smoke for at least 20 minutes.	Pattern	Minimal harm or potential for actual harm
06/09/2009	exits that are accessible at all times.	Pattern	Minimal harm or potential for actual harm
06/09/2009	posted "No-smoking" signs in areas where smoking is not permitted or did not provide ashtrays where smoking was allowed.	Pattern	Minimal harm or potential for actual harm
06/09/2009	Properly hold, secure and manage each resident's personal money which is deposited with the nursing home.	Pattern	Minimal harm or potential for actual harm
06/09/2009	Allow residents to easily see the results of the nursing home's most recent survey.	Isolated	Minimal harm or potential for actual harm
04/11/2008	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
04/11/2008	proper stairway enclosures and vertical shafts.	Isolated	Minimal harm or potential for actual harm
04/11/2008	Have enough outside airflow.	Isolated	Minimal harm or potential for actual harm
04/11/2008	Follow all laws and professional standards.	Isolated	Minimal harm or potential for actual harm
04/11/2008	Have a detailed, written plan for disasters and emergencies.	Isolated	Minimal harm or potential for actual harm
04/11/2008	smoke barrier doors that can resist smoke for at least 20 minutes.	Isolated	Minimal harm or potential for actual harm
04/11/2008	exits that are accessible at all times.	Pattern	Minimal harm or potential for actual harm
04/11/2008	an approved installation, maintenance and testing program for fire alarm systems.	Isolated	Minimal harm or potential for actual harm
04/11/2008	automatic sprinkler systems that have been maintained in working order.	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