CHILDRENS COMPREHENSIVE CARE CENTER FL DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
12/24/2008	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
12/24/2008	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
12/24/2008	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
12/24/2008	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
12/24/2008	Give or get special rehabilitation if in the patient's plan of care.	Pattern	Minimal harm or potential for actual harm
12/24/2008	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
12/24/2008	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
12/24/2008	Make sure that a working call system is available in each resident's room or bathroom and bathing area.	Pattern	Minimal harm or potential for actual harm
12/24/2008	Get rid of garbage properly.	Widespread	Potential for minimal harm
12/24/2008	Provide needed housekeeping and maintenance.	Isolated	Minimal harm or potential for actual harm
12/24/2008	Give or get lab tests to meet the needs of residents.	Isolated	Minimal harm or potential for actual harm
12/22/2008	properly sized and located linen or trash receptacles.	Isolated	Minimal harm or potential for actual harm
12/22/2008	properly maintained smoke detectors.	Widespread	Minimal harm or potential for actual harm
01/16/2008	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	Potential for minimal harm
01/16/2008	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
01/16/2008	Develop/implement required procedures for the administration of immunizations.	Pattern	Minimal harm or potential for actual harm
01/16/2008	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
01/16/2008	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
01/16/2008	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
01/16/2008	Make sure that residents are well nourished.	Isolated	Minimal harm or potential for actual harm
01/16/2008	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Widespread	Potential for minimal harm
01/16/2008	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.	Isolated	Minimal harm or potential for actual harm
01/16/2008	Get rid of garbage properly.	Widespread	Potential for minimal harm
01/16/2008	Provide needed housekeeping and maintenance.	Isolated	Minimal harm or potential for actual harm
01/14/2008	smoke barrier doors that can resist smoke for at least 20 minutes.	Widespread	Minimal harm or potential for actual harm
01/14/2008	properly constructed piped-in oxygen systems.	Widespread	Minimal harm or potential for actual harm
12/21/2006	Try to resolve each resident's complaints quickly.	Pattern	Minimal harm or potential for actual harm
12/21/2006	Keep each resident's personal and medical records private and confidential.	Isolated	Minimal harm or potential for actual harm
12/21/2006	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
12/21/2006	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
12/21/2006	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
12/21/2006	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
12/21/2006	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Isolated	Minimal harm or potential for actual harm
12/21/2006	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
12/21/2006	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
12/21/2006	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
12/21/2006	Make sure that the attending doctor orders special diets.	Isolated	Minimal harm or potential for actual harm
12/21/2006	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
12/21/2006	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
12/21/2006	Hire enough skilled workers to carry out dietary service.	Widespread	Minimal harm or potential for actual harm
12/21/2006	Provide a tasty and well-balanced diet that meets the nutritional needs of each resident.	Widespread	Minimal harm or potential for actual harm
12/21/2006	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.	Isolated	Minimal harm or potential for actual harm
12/21/2006	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
12/20/2006	fire safety features required by current fire safety codes.	Widespread	Minimal harm or potential for actual harm
12/20/2006	properly maintained smoke detectors.	Widespread	Minimal harm or potential for actual harm
12/20/2006	an approved installation, maintenance and testing program for fire alarm systems.	Widespread	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