HORIZON WEST - PLACERVILLE CA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
01/12/2010	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
01/12/2010	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
01/12/2010	exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detectors.	Isolated	Minimal harm or potential for actual harm
01/12/2010	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
01/12/2010	smoke barrier doors that can resist smoke for at least 20 minutes.	Isolated	Minimal harm or potential for actual harm
01/12/2010	properly maintained smoke detectors.	Widespread	Minimal harm or potential for actual harm
01/12/2010	an approved automatic sprinkler system connected to the fire alarm system.	Widespread	Potential for minimal harm
01/12/2010	weekly inspections and monthly testing of generators.	Pattern	Minimal harm or potential for actual harm
01/12/2010	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
01/07/2010	Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged.	Isolated	Minimal harm or potential for actual harm
01/07/2010	Make sure that each resident has the right to join in social, religious, and community activities.	Isolated	Minimal harm or potential for actual harm
01/07/2010	Keep safe, clean and homelike surroundings.	Isolated	Minimal harm or potential for actual harm
01/07/2010	Do an assessment of the resident every year.	Isolated	Minimal harm or potential for actual harm
01/07/2010	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
01/07/2010	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
01/07/2010	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
01/07/2010	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
01/07/2010	Have drugs and other similar products available, which are needed every day and in emergencies, and give them out properly.	Pattern	Minimal harm or potential for actual harm
01/07/2010	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
01/07/2010	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
01/07/2010	Provide rooms that are big enough for each resident.	Widespread	Potential for minimal harm
01/07/2010	Put firmly secured handrails on each side of hallways.	Pattern	Minimal harm or potential for actual harm
01/07/2010	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
10/22/2008	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
10/22/2008	exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detectors.	Isolated	Minimal harm or potential for actual harm
10/22/2008	smoke barrier doors that can resist smoke for at least 20 minutes.	Isolated	Minimal harm or potential for actual harm
10/22/2008	portable fire extinguishers.	Isolated	Minimal harm or potential for actual harm
10/22/2008	heating and ventilation systems that have been properly installed according to the manufacturer's instructions.	Isolated	Minimal harm or potential for actual harm
10/22/2008	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
10/22/2008	back-up procedures in place for a faulty automatic sprinkler system.	Isolated	Minimal harm or potential for actual harm
10/22/2008	an approved back-up procedure for a faulty fire alarm system.	Isolated	Minimal harm or potential for actual harm
10/22/2008	properly installed hallway dispensers for alcohol-based hand rub.	Pattern	Minimal harm or potential for actual harm
10/17/2008	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
10/17/2008	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
10/17/2008	Keep safe, clean and homelike surroundings.	Isolated	Minimal harm or potential for actual harm
10/17/2008	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
10/17/2008	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
10/17/2008	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
10/17/2008	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
10/17/2008	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Pattern	Minimal harm or potential for actual harm
10/17/2008	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
10/17/2008	Keep all essential equipment working safely.	Pattern	Potential for minimal harm
10/17/2008	Provide rooms that are big enough for each resident.	Widespread	Potential for minimal harm
10/17/2008	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
11/01/2007	corridor and hallway doors that block smoke.	Pattern	Potential for minimal harm
11/01/2007	an approved installation, maintenance and testing program for fire alarm systems.	Widespread	Potential for minimal harm
11/01/2007	properly maintained smoke detectors.	Isolated	Minimal harm or potential for actual harm
11/01/2007	restrictions on the use of highly flammable materials.	Isolated	Minimal harm or potential for actual harm
11/01/2007	proper medical gas storage and administration areas.	Isolated	Minimal harm or potential for actual harm
11/01/2007	weekly inspections and monthly testing of generators.	Widespread	Potential for minimal harm
11/01/2007	properly installed electrical wiring and equipment.	Pattern	Potential for minimal harm
10/26/2007	Let the resident refuse treatment or refuse to take part in an experiment.	Isolated	Minimal harm or potential for actual harm
10/26/2007	Provide written records when a resident is transferred or discharged.	Isolated	Minimal harm or potential for actual harm
10/26/2007	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
10/26/2007	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
10/26/2007	Keep safe, clean and homelike surroundings.	Pattern	Minimal harm or potential for actual harm
10/26/2007	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
10/26/2007	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
10/26/2007	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
10/26/2007	Make sure that residents are safe from serious medication errors.	Pattern	Minimal harm or potential for actual harm
10/26/2007	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
10/26/2007	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Isolated	Minimal harm or potential for actual harm
10/26/2007	Properly mark drugs and other similar products.	Pattern	Minimal harm or potential for actual harm
10/26/2007	Provide rooms that are big enough for each resident.	Widespread	Potential for minimal harm
10/26/2007	Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person.	Pattern	Minimal harm or potential for actual harm
10/26/2007	Train all employees on what to do in an emergency.	Pattern	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