GOLDEN LIVINGCENTER - NAPA CA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
07/09/2010	approved construction type or materials.	Pattern	Minimal harm or potential for actual harm
07/09/2010	corridor and hallway doors that block smoke.	Widespread	Minimal harm or potential for actual harm
07/09/2010	walls or barriers that prevent smoke from passing through and would resist fire for at least one hour.	Widespread	Minimal harm or potential for actual harm
07/09/2010	smoke barrier doors that can resist smoke for at least 20 minutes.	Widespread	Minimal harm or potential for actual harm
07/09/2010	emergency lighting that can last at least 1 1/2 hours.	Widespread	Potential for minimal harm
07/09/2010	properly located and lighted "Exit" signs.	Isolated	Minimal harm or potential for actual harm
07/09/2010	a fire alarm system that can be heard throughout the facility.	Isolated	Minimal harm or potential for actual harm
07/09/2010	an approved installation, maintenance and testing program for fire alarm systems.	Isolated	Minimal harm or potential for actual harm
07/09/2010	properly maintained smoke detectors.	Pattern	Minimal harm or potential for actual harm
07/09/2010	properly working alarms on sprinkler valves.	Pattern	Minimal harm or potential for actual harm
07/09/2010	automatic sprinkler systems that have been maintained in working order.	Pattern	Minimal harm or potential for actual harm
07/09/2010	portable fire extinguishers.	Isolated	Minimal harm or potential for actual harm
07/09/2010	properly protected cooking facilities.	Pattern	Minimal harm or potential for actual harm
07/09/2010	exits that are free from obstructions and can be used at all times.	Pattern	Minimal harm or potential for actual harm
07/09/2010	proper medical gas storage and administration areas.	Isolated	Minimal harm or potential for actual harm
07/09/2010	weekly inspections and monthly testing of generators.	Pattern	Minimal harm or potential for actual harm
07/09/2010	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
07/02/2010	Try to resolve each resident's complaints quickly.	Isolated	Minimal harm or potential for actual harm
07/02/2010	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
07/02/2010	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
07/02/2010	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
07/02/2010	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
07/02/2010	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
07/02/2010	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
07/02/2010	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
07/02/2010	Have enough backup water supply for important areas of the nursing home.	Widespread	Minimal harm or potential for actual harm
07/02/2010	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
07/02/2010	Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person.	Pattern	Potential for minimal harm
07/02/2010	Have a detailed, written plan for disasters and emergencies.	Widespread	Potential for minimal harm
07/02/2010	Train all employees on what to do in an emergency.	Pattern	Minimal harm or potential for actual harm
07/08/2009	smoke barrier doors that can resist smoke for at least 20 minutes.	Isolated	Minimal harm or potential for actual harm
07/08/2009	exits that are accessible at all times.	Isolated	Minimal harm or potential for actual harm
07/08/2009	properly maintained smoke detectors.	Isolated	Minimal harm or potential for actual harm
07/08/2009	an approved automatic sprinkler system connected to the fire alarm system.	Widespread	Minimal harm or potential for actual harm
07/08/2009	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
06/26/2009	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
06/26/2009	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
06/26/2009	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
06/26/2009	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
06/26/2009	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
06/26/2009	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
06/26/2009	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
06/26/2009	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
06/26/2009	Hire a qualified dietician.	Pattern	Minimal harm or potential for actual harm
06/26/2009	Hire enough skilled workers to carry out dietary service.	Isolated	Minimal harm or potential for actual harm
06/26/2009	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
06/26/2009	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
06/26/2009	Make sure that the attending doctor orders special diets.	Pattern	Minimal harm or potential for actual harm
06/26/2009	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
06/26/2009	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
06/26/2009	Keep all essential equipment working safely.	Isolated	Minimal harm or potential for actual harm
06/26/2009	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
08/21/2008	construction that can resist fire for one hour or an approved fire extinguishing system.	Isolated	Minimal harm or potential for actual harm
08/21/2008	an approved installation, maintenance and testing program for fire alarm systems.	Isolated	Minimal harm or potential for actual harm
08/21/2008	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
08/21/2008	properly maintained smoke detectors.	Isolated	Minimal harm or potential for actual harm
08/21/2008	properly working alarms on sprinkler valves.	Pattern	Minimal harm or potential for actual harm
08/21/2008	automatic sprinkler systems that have been maintained in working order.	Isolated	Minimal harm or potential for actual harm
08/21/2008	properly protected cooking facilities.	Pattern	Minimal harm or potential for actual harm
08/21/2008	exits that are free from obstructions and can be used at all times.	Isolated	Minimal harm or potential for actual harm
08/21/2008	restrictions on the use of flammable curtains.	Pattern	Minimal harm or potential for actual harm
08/21/2008	fire safety features required by current fire safety codes.	Isolated	Minimal harm or potential for actual harm
07/25/2008	Allow residents to easily see the results of the nursing home's most recent survey.	Pattern	Potential for minimal harm
07/25/2008	Provide activities to meet the needs of each resident.	Isolated	Minimal harm or potential for actual harm
07/25/2008	Assess the resident when the resident enters the nursing home, in a timely manner.	Isolated	Minimal harm or potential for actual harm
07/25/2008	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
07/25/2008	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
07/25/2008	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
07/25/2008	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
07/25/2008	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
07/25/2008	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
07/25/2008	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
07/25/2008	Be designed, built, equipped, or well kept to protect the health and safety of residents, workers, and the public.	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