GOLDEN LIVINGCENTER - LONDON HOUSE SONOMA CA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
12/09/2010	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
12/09/2010	construction that can resist fire for one hour or an approved fire extinguishing system.	Isolated	Minimal harm or potential for actual harm
12/09/2010	restrictions on the use of highly flammable materials.	Pattern	Minimal harm or potential for actual harm
12/09/2010	restrictions on the use of flammable curtains.	Isolated	Minimal harm or potential for actual harm
12/09/2010	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
11/19/2010	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Isolated	Minimal harm or potential for actual harm
11/19/2010	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
11/19/2010	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
11/19/2010	Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.	Isolated	Minimal harm or potential for actual harm
11/19/2010	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
11/19/2010	Give or get special rehabilitation if in the patient's plan of care.	Isolated	Minimal harm or potential for actual harm
11/19/2010	Properly mark drugs and other similar products.	Pattern	Minimal harm or potential for actual harm
11/19/2010	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
11/19/2010	Train all employees on what to do in an emergency.	Pattern	Minimal harm or potential for actual harm
01/05/2010	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
01/05/2010	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
01/05/2010	record of quarterly fire drills for each shift under varying conditions.	Isolated	Minimal harm or potential for actual harm
01/05/2010	automatic sprinkler systems that have been maintained in working order.	Isolated	Minimal harm or potential for actual harm
01/05/2010	portable fire extinguishers.	Pattern	Minimal harm or potential for actual harm
01/05/2010	proper medical gas storage and administration areas.	Isolated	Minimal harm or potential for actual harm
01/05/2010	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
11/23/2009	Protect residents from mistreatment, neglect, and/or theft of personal property.	Isolated	Minimal harm or potential for actual harm
11/23/2009	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
11/23/2009	Keep sound levels comfortable.	Pattern	Minimal harm or potential for actual harm
11/23/2009	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.	Pattern	Minimal harm or potential for actual harm
11/23/2009	Give each resident care and services to get or keep the highest quality of life possible.	Pattern	Minimal harm or potential for actual harm
11/23/2009	Make sure that each resident who enters the nursing home without a catheter is not given a catheter, unless it is necessary.	Pattern	Minimal harm or potential for actual harm
11/23/2009	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
11/23/2009	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	Potential for minimal harm
11/23/2009	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
11/23/2009	Have a program to keep infection from spreading.	Widespread	Minimal harm or potential for actual harm
11/23/2009	Keep accurate and appropriate medical records.	Pattern	Minimal harm or potential for actual harm
11/18/2008	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
11/18/2008	record of quarterly fire drills for each shift under varying conditions.	Isolated	Minimal harm or potential for actual harm
11/18/2008	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
11/03/2008	Keep each resident's personal and medical records private and confidential.	Isolated	Minimal harm or potential for actual harm
11/03/2008	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
11/03/2008	Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.	Isolated	Minimal harm or potential for actual harm
11/03/2008	Give proper treatment to residents with feeding tubes to prevent problems (such as aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, nasal-pharyngeal ulcers) and help restore eating skills, if possible.	Isolated	Minimal harm or potential for actual harm
11/03/2008	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
11/03/2008	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
11/03/2008	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
11/03/2008	Provide food in a way that meets a resident's needs.	Isolated	Minimal harm or potential for actual harm
11/03/2008	Offer other nutritional food to each resident who will not eat the food served.	Pattern	Minimal harm or potential for actual harm
11/03/2008	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
11/03/2008	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
11/03/2008	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
11/03/2008	Properly mark drugs and other similar products.	Pattern	Minimal harm or potential for actual harm
11/03/2008	Have a detailed, written plan for disasters and emergencies.	Widespread	Minimal harm or potential for actual harm

Have you or someone you know become a victim of nursing home abuse or neglect? If so, contact one of our experienced nursing home lawyers today. Help End Nursing Home Abuse

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