GUARDIAN REHABILITATION HOSP CA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
06/11/2010	exits that are accessible at all times.	Pattern	Minimal harm or potential for actual harm
06/11/2010	a fire alarm system that can be heard throughout the facility.	Pattern	Minimal harm or potential for actual harm
06/11/2010	automatic sprinkler systems that have been maintained in working order.	Pattern	Minimal harm or potential for actual harm
06/11/2010	exits that are free from obstructions and can be used at all times.	Pattern	Minimal harm or potential for actual harm
06/11/2010	no-smoking signs where oxygen is used.	Isolated	Minimal harm or potential for actual harm
06/11/2010	weekly inspections and monthly testing of generators.	Widespread	Minimal harm or potential for actual harm
05/20/2010	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	Minimal harm or potential for actual harm
05/20/2010	Let residents give themselves their drugs if they are able.	Isolated	Minimal harm or potential for actual harm
05/20/2010	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
05/20/2010	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
05/20/2010	Provide services to meet the needs and preferences of each resident.	Pattern	Minimal harm or potential for actual harm
05/20/2010	Provide activities to meet the needs of each resident.	Pattern	Minimal harm or potential for actual harm
05/20/2010	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
05/20/2010	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
05/20/2010	Give each resident care and services to get or keep the highest quality of life possible.	Pattern	Minimal harm or potential for actual harm
05/20/2010	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
05/20/2010	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Actual harm
05/20/2010	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
05/20/2010	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
05/20/2010	Have a program to keep infection from spreading.	Widespread	Minimal harm or potential for actual harm
05/20/2010	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Minimal harm or potential for actual harm
05/20/2010	Keep accurate and appropriate medical records.	Pattern	Minimal harm or potential for actual harm
02/12/2009	Keep temperature levels comfortable and safe.	Pattern	Minimal harm or potential for actual harm
02/12/2009	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
02/12/2009	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
02/12/2009	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
02/12/2009	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
02/12/2009	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
02/12/2009	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
02/11/2009	fire-resistant room wall surfaces.	Pattern	Minimal harm or potential for actual harm
02/11/2009	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
02/11/2009	proper stairway enclosures and vertical shafts.	Pattern	Minimal harm or potential for actual harm
02/11/2009	emergency lighting that can last at least 1 1/2 hours.	Widespread	Minimal harm or potential for actual harm
02/11/2009	properly located and lighted "Exit" signs.	Widespread	Minimal harm or potential for actual harm
02/11/2009	properly maintained smoke detectors.	Isolated	Minimal harm or potential for actual harm
02/11/2009	heating and ventilation systems that have been properly installed according to the manufacturer's instructions.	Pattern	Minimal harm or potential for actual harm
02/11/2009	exits that are free from obstructions and can be used at all times.	Isolated	Minimal harm or potential for actual harm
02/11/2009	fire safety features required by current fire safety codes.	Widespread	Minimal harm or potential for actual harm
02/11/2009	weekly inspections and monthly testing of generators.	Widespread	Minimal harm or potential for actual harm
02/11/2009	a separate and independent backup electrical power source.	Widespread	Minimal harm or potential for actual harm
11/08/2007	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
11/06/2007	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
11/06/2007	Provide activities to meet the needs of each resident.	Isolated	Minimal harm or potential for actual harm
11/06/2007	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
11/06/2007	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
11/06/2007	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
11/06/2007	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
11/06/2007	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
11/06/2007	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
11/06/2007	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

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