HAYWARD HILLS HEALTH CARE CENTER CA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
10/14/2009	approved construction type or materials.	Pattern	Minimal harm or potential for actual harm
10/14/2009	exits that are accessible at all times.	Isolated	Minimal harm or potential for actual harm
10/14/2009	a fire alarm system that can be heard throughout the facility.	Widespread	Minimal harm or potential for actual harm
10/14/2009	automatic sprinkler systems that have been maintained in working order.	Pattern	Minimal harm or potential for actual harm
10/14/2009	restrictions on the use of highly flammable materials.	Isolated	Minimal harm or potential for actual harm
10/14/2009	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
10/08/2009	Protect each resident from all abuse, physical punishment, and being separated from others.	Isolated	Actual harm
10/08/2009	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Minimal harm or potential for actual harm
10/08/2009	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
10/08/2009	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
10/08/2009	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
10/08/2009	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
10/08/2009	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Potential for minimal harm
10/08/2009	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
10/08/2009	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
10/08/2009	Have a detailed, written plan for disasters and emergencies.	Pattern	Potential for minimal harm
08/26/2008	construction that can resist fire for one hour or an approved fire extinguishing system.	Isolated	Minimal harm or potential for actual harm
08/26/2008	automatic sprinkler systems that have been maintained in working order.	Widespread	Potential for minimal harm
08/26/2008	restrictions on the use of highly flammable materials.	Isolated	Minimal harm or potential for actual harm
08/26/2008	proper medical gas storage and administration areas.	Widespread	Potential for minimal harm
08/26/2008	proper power supply for life support equipment.	Isolated	Minimal harm or potential for actual harm
08/26/2008	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
08/14/2008	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
08/14/2008	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
08/14/2008	Keep assessments completed in the preceding 15 months in the resident's active record.	Isolated	Minimal harm or potential for actual harm
08/14/2008	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
08/14/2008	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
08/14/2008	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
07/03/2007	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
07/03/2007	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
07/03/2007	exits that are accessible at all times.	Isolated	Minimal harm or potential for actual harm
07/03/2007	did not have a written emergency evacuation plan.	Widespread	Potential for minimal harm
07/03/2007	automatic sprinkler systems that have been maintained in working order.	Widespread	Minimal harm or potential for actual harm
07/03/2007	exits that are free from obstructions and can be used at all times.	Widespread	Minimal harm or potential for actual harm
07/03/2007	back-up procedures in place for a faulty automatic sprinkler system.	Widespread	Potential for minimal harm
07/03/2007	an approved back-up procedure for a faulty fire alarm system.	Widespread	Potential for minimal harm
06/21/2007	Keep each resident's personal and medical records private and confidential.	Isolated	Minimal harm or potential for actual harm
06/21/2007	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
06/21/2007	Provide activities to meet the needs of each resident.	Isolated	Minimal harm or potential for actual harm
06/21/2007	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
06/21/2007	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
06/21/2007	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
06/21/2007	Give special rehabilitation by skilled workers, when ordered by a doctor.	Isolated	Minimal harm or potential for actual harm
06/21/2007	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
06/21/2007	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
06/21/2007	Keep all essential equipment working safely.	Pattern	Potential for minimal harm
06/21/2007	Choose a doctor to be the medical director.	Isolated	Minimal harm or potential for actual harm
06/21/2007	Have a detailed, written plan for disasters and emergencies.	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