CENTINELA GRAND INC CA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
03/24/2010	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
03/24/2010	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
03/24/2010	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
03/24/2010	Keep sound levels comfortable.	Pattern	Minimal harm or potential for actual harm
03/24/2010	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
03/24/2010	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
03/24/2010	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.	Isolated	Minimal harm or potential for actual harm
03/24/2010	Give each resident care and services to get or keep the highest quality of life possible.	Pattern	Minimal harm or potential for actual harm
03/24/2010	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
03/24/2010	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
03/24/2010	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
03/24/2010	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
03/24/2010	post nurse staffing information.	Isolated	Minimal harm or potential for actual harm
03/24/2010	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
03/24/2010	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.	Isolated	Minimal harm or potential for actual harm
03/24/2010	Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing.	Pattern	Minimal harm or potential for actual harm
03/24/2010	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
03/24/2010	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
03/24/2010	Make sure each resident has 1) at least one window to the outside in a room; 2) a room at or above ground level; 3) an adequate bed; 4) furniture that meets the resident's needs; or 5) enough closet space.	Isolated	Minimal harm or potential for actual harm
03/24/2010	Put a bathroom in or next to each resident's room.	Isolated	Minimal harm or potential for actual harm
03/24/2010	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
03/24/2010	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Isolated	Minimal harm or potential for actual harm
03/24/2010	Follow all laws and professional standards.	Isolated	Minimal harm or potential for actual harm
03/24/2010	1) Set up a group that is legally responsible for writing and setting up policies for leading and running the nursing home; or 2) hire a properly licensed administrator.	Isolated	Minimal harm or potential for actual harm
03/24/2010	Honor all of the resident's rights as a resident of the nursing home and as a citizen or resident of the United States.	Pattern	Minimal harm or potential for actual harm
03/24/2010	Provide proof that all residents' personal money which is deposited with the nursing home, is secure.	Widespread	Minimal harm or potential for actual harm
03/24/2010	Allow residents to easily see the results of the nursing home's most recent survey.	Widespread	Potential for minimal harm
03/24/2010	Provide written records when a resident is transferred or discharged.	Isolated	Minimal harm or potential for actual harm
03/24/2010	Protect residents from mistreatment, neglect, and/or theft of personal property.	Isolated	Minimal harm or potential for actual harm
03/24/2010	Provide care for each resident in a way that keeps or builds the resident's quality of life.	Pattern	Minimal harm or potential for actual harm
03/24/2010	Choose a doctor to be the medical director.	Pattern	Minimal harm or potential for actual harm
03/24/2010	Keep accurate and appropriate medical records.	Pattern	Minimal harm or potential for actual harm
03/24/2010	Have an agreement with at least one hospital certified by Medicare or Medicaid to make sure residents can be moved quickly to the hospital when they need medical care.	Widespread	Minimal harm or potential for actual harm
03/23/2010	approved construction type or materials.	Pattern	Minimal harm or potential for actual harm
03/23/2010	corridors that are separated from common areas by walls constructed to limit the passage of smoke.	Isolated	Minimal harm or potential for actual harm
03/23/2010	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
03/23/2010	properly located and lighted "Exit" signs.	Isolated	Minimal harm or potential for actual harm
03/23/2010	record of quarterly fire drills for each shift under varying conditions.	Widespread	Potential for minimal harm
03/23/2010	an approved installation, maintenance and testing program for fire alarm systems.	Widespread	Potential for minimal harm
03/23/2010	properly maintained smoke detectors.	Widespread	Potential for minimal harm
03/23/2010	properly working sprinkler alarm system.	Widespread	Minimal harm or potential for actual harm
03/23/2010	automatic sprinkler systems that have been maintained in working order.	Pattern	Minimal harm or potential for actual harm
03/23/2010	portable fire extinguishers.	Isolated	Minimal harm or potential for actual harm
03/23/2010	proper medical gas storage and administration areas.	Isolated	Minimal harm or potential for actual harm
03/23/2010	weekly inspections and monthly testing of generators.	Pattern	Minimal harm or potential for actual harm
03/23/2010	properly installed electrical wiring and equipment.	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	corridor and hallway doors that block smoke.	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.	Isolated	Minimal harm or potential for actual harm
06/09/2009	construction that can resist fire for one hour or an approved fire extinguishing system.	Pattern	Minimal harm or potential for actual harm
06/09/2009	record of quarterly fire drills for each shift under varying conditions.	Pattern	Minimal harm or potential for actual harm
06/09/2009	a fire alarm system that can be heard throughout the facility.	Isolated	Minimal harm or potential for actual harm
06/09/2009	properly maintained smoke detectors.	Pattern	Minimal harm or potential for actual harm
06/09/2009	portable fire extinguishers.	Isolated	Minimal harm or potential for actual harm
06/09/2009	proper medical gas storage and administration areas.	Isolated	Minimal harm or potential for actual harm
06/09/2009	fire safety features required by current fire safety codes.	Isolated	Minimal harm or potential for actual harm
06/09/2009	no-smoking signs where oxygen is used.	Pattern	Minimal harm or potential for actual harm
06/09/2009	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
06/05/2009	Tell the resident completely about his or her health status.	Isolated	Minimal harm or potential for actual harm
06/05/2009	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.	Widespread	Potential for minimal harm
06/05/2009	Listen to the resident or family groups or act on their complaints or suggestions.	Pattern	Minimal harm or potential for actual harm
06/05/2009	Do an assessment of the resident every year.	Isolated	Minimal harm or potential for actual harm
06/05/2009	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
06/05/2009	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
06/05/2009	Develop/implement required procedures for the administration of immunizations.	Isolated	Minimal harm or potential for actual harm
06/05/2009	Make sure that the attending doctor orders special diets.	Isolated	Minimal harm or potential for actual harm
06/05/2009	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
06/05/2009	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
06/05/2009	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
06/05/2009	Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person.	Widespread	Potential for minimal harm
06/05/2009	Train all employees on what to do in an emergency.	Isolated	Minimal harm or potential for actual harm
05/01/2008	approved construction type or materials.	Pattern	Minimal harm or potential for actual harm
05/01/2008	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
05/01/2008	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
05/01/2008	construction that can resist fire for one hour or an approved fire extinguishing system.	Isolated	Minimal harm or potential for actual harm
05/01/2008	record of quarterly fire drills for each shift under varying conditions.	Widespread	Potential for minimal harm
05/01/2008	an approved installation, maintenance and testing program for fire alarm systems.	Isolated	Minimal harm or potential for actual harm
05/01/2008	posted "No-smoking" signs in areas where smoking is not permitted or did not provide ashtrays where smoking was allowed.	Isolated	Minimal harm or potential for actual harm
05/01/2008	heating and ventilation systems that have been properly installed according to the manufacturer's instructions.	Isolated	Minimal harm or potential for actual harm
05/01/2008	exits that are free from obstructions and can be used at all times.	Isolated	Minimal harm or potential for actual harm
05/01/2008	weekly inspections and monthly testing of generators.	Pattern	Potential for minimal harm
04/25/2008	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
04/25/2008	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
04/25/2008	Keep sound levels comfortable.	Pattern	Minimal harm or potential for actual harm
04/25/2008	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
04/25/2008	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
04/25/2008	Make sure that each residents' abilities to take care of themselves does not lessen, unless a change cannot be avoided.	Isolated	Minimal harm or potential for actual harm
04/25/2008	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
04/25/2008	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
04/25/2008	Make sure that residents are safe from serious medication errors.	Pattern	Minimal harm or potential for actual harm
04/25/2008	Hire enough skilled workers to carry out dietary service.	Isolated	Minimal harm or potential for actual harm
04/25/2008	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
04/25/2008	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
04/25/2008	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
04/25/2008	Have a program to keep infection from spreading.	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