HELIA HEALTHCARE OF ROLLA MO DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
03/16/2010	Keep each resident's personal and medical records private and confidential.	Isolated	Minimal harm or potential for actual harm
03/16/2010	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
03/16/2010	Provide activities to meet the needs of each resident.	Isolated	Minimal harm or potential for actual harm
03/16/2010	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
03/16/2010	Keep sound levels comfortable.	Pattern	Minimal harm or potential for actual harm
03/16/2010	Do an assessment of the resident every year.	Isolated	Minimal harm or potential for actual harm
03/16/2010	Check and update (if needed) each resident's assessment every 3 months.	Isolated	Minimal harm or potential for actual harm
03/16/2010	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
03/16/2010	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
03/16/2010	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
03/16/2010	Give professional services that follow each resident's written care plan.	Pattern	Minimal harm or potential for actual harm
03/16/2010	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
03/16/2010	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
03/16/2010	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Pattern	Actual harm
03/16/2010	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
03/16/2010	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
03/16/2010	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
03/16/2010	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
03/16/2010	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
03/16/2010	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
03/16/2010	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
03/16/2010	Keep all essential equipment working safely.	Pattern	Minimal harm or potential for actual harm
03/16/2010	Be administered in a way that leads to the highest possible level of well being for each resident.	Widespread	Minimal harm or potential for actual harm
03/16/2010	Set up or keep a group of people to review and ensure quality.	Widespread	Minimal harm or potential for actual harm
09/21/2009	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
09/21/2009	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
09/21/2009	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
09/21/2009	Keep safe, clean and homelike surroundings.	Pattern	Minimal harm or potential for actual harm
09/21/2009	Provide clean bed and bath linens that are in good condition.	Isolated	Minimal harm or potential for actual harm
09/21/2009	Do a new assessment after any major change in a resident's physical or mental health.	Isolated	Minimal harm or potential for actual harm
09/21/2009	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Pattern	Minimal harm or potential for actual harm
09/21/2009	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
09/21/2009	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Immediate jeopardy to resident health or safety
09/21/2009	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
09/21/2009	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Pattern	Actual harm
09/21/2009	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
09/21/2009	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
09/21/2009	Give each resident enough fluids to keep them healthy and prevent dehydration.	Isolated	Actual harm
09/21/2009	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
09/21/2009	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
09/21/2009	Develop/implement required procedures for the administration of immunizations.	Isolated	Minimal harm or potential for actual harm
09/21/2009	Have enough nurses to care for every resident in a way that maximizes the resident's well being.	Pattern	Minimal harm or potential for actual harm
09/21/2009	Use a registered nurse at least 8 hours a day, 7 days a week.	Isolated	Minimal harm or potential for actual harm
09/21/2009	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Widespread	Minimal harm or potential for actual harm
09/21/2009	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
09/21/2009	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
09/21/2009	Make sure there is a program to prevent/deal with mice, insects, or other pests.	Pattern	Minimal harm or potential for actual harm
09/21/2009	Be administered in a way that leads to the highest possible level of well being for each resident.	Widespread	Minimal harm or potential for actual harm
09/21/2009	Choose a doctor to be the medical director.	Isolated	Minimal harm or potential for actual harm
09/21/2009	corridors that are separated from common areas by walls constructed to limit the passage of smoke.	Widespread	Minimal harm or potential for actual harm
09/21/2009	corridor and hallway doors that block smoke.	Widespread	Minimal harm or potential for actual harm
09/21/2009	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
09/21/2009	record of quarterly fire drills for each shift under varying conditions.	Widespread	Minimal harm or potential for actual harm
09/21/2009	a fire alarm system that can be heard throughout the facility.	Widespread	Minimal harm or potential for actual harm
09/21/2009	an approved automatic sprinkler system connected to the fire alarm system.	Widespread	Minimal harm or potential for actual harm
09/21/2009	automatic sprinkler systems that have been maintained in working order.	Widespread	Minimal harm or potential for actual harm
09/21/2009	posted "No-smoking" signs in areas where smoking is not permitted or did not provide ashtrays where smoking was allowed.	Widespread	Minimal harm or potential for actual harm
09/21/2009	restrictions on the use of flammable curtains.	Widespread	Minimal harm or potential for actual harm
10/24/2008	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
10/24/2008	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
10/24/2008	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
10/24/2008	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Minimal harm or potential for actual harm
10/24/2008	Assess the resident when the resident enters the nursing home, in a timely manner.	Isolated	Minimal harm or potential for actual harm
10/24/2008	Do an assessment of the resident every year.	Isolated	Minimal harm or potential for actual harm
10/24/2008	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
10/24/2008	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
10/24/2008	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
10/24/2008	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
10/24/2008	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
10/24/2008	Develop/implement required procedures for the administration of immunizations.	Pattern	Minimal harm or potential for actual harm
10/24/2008	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
10/24/2008	Offer other nutritional food to each resident who will not eat the food served.	Isolated	Minimal harm or potential for actual harm
10/24/2008	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
10/24/2008	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
10/24/2008	Hire nurse aides who have completed required training and shown that they are skilled.	Isolated	Minimal harm or potential for actual harm
10/24/2008	approved construction type or materials.	Widespread	Minimal harm or potential for actual harm
10/24/2008	a separate and independent backup electrical power source.	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