HY-LOND HEALTH CARE CENTER - MODESTO CA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
09/15/2010	automatic sprinkler systems that have been maintained in working order.	Widespread	Minimal harm or potential for actual harm
09/15/2010	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
09/15/2010	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
09/15/2010	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
09/15/2010	properly located and lighted "Exit" signs.	Isolated	Minimal harm or potential for actual harm
09/15/2010	did not have a written emergency evacuation plan.	Pattern	Minimal harm or potential for actual harm
09/15/2010	an approved installation, maintenance and testing program for fire alarm systems.	Pattern	Minimal harm or potential for actual harm
09/15/2010	properly maintained smoke detectors.	Widespread	Minimal harm or potential for actual harm
09/15/2010	heating and ventilation systems that have been properly installed according to the manufacturer's instructions.	Widespread	Minimal harm or potential for actual harm
09/15/2010	restrictions on the use of portable space heaters.	Isolated	Minimal harm or potential for actual harm
09/15/2010	weekly inspections and monthly testing of generators.	Widespread	Minimal harm or potential for actual harm
09/15/2010	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
09/15/2010	properly installed hallway dispensers for alcohol-based hand rub.	Isolated	Minimal harm or potential for actual harm
08/20/2010	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
08/20/2010	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
08/20/2010	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
08/20/2010	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
08/20/2010	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
05/21/2009	approved construction type or materials.	Widespread	Minimal harm or potential for actual harm
05/21/2009	automatic sprinkler systems that have been maintained in working order.	Isolated	Minimal harm or potential for actual harm
05/21/2009	portable fire extinguishers.	Isolated	Minimal harm or potential for actual harm
05/21/2009	weekly inspections and monthly testing of generators.	Widespread	Potential for minimal harm
05/21/2009	properly installed electrical wiring and equipment.	Widespread	Minimal harm or potential for actual harm
05/21/2009	properly installed hallway dispensers for alcohol-based hand rub.	Isolated	Minimal harm or potential for actual harm
05/07/2009	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Minimal harm or potential for actual harm
05/07/2009	Do a new assessment after any major change in a resident's physical or mental health.	Isolated	Minimal harm or potential for actual harm
05/07/2009	Check and update (if needed) each resident's assessment every 3 months.	Isolated	Minimal harm or potential for actual harm
05/07/2009	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
05/07/2009	Keep assessments completed in the preceding 15 months in the resident's active record.	Isolated	Minimal harm or potential for actual harm
05/07/2009	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
05/07/2009	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
05/07/2009	Prevent a loss in range of motion among residents who entered the nursing home with a full range of motion.	Isolated	Minimal harm or potential for actual harm
05/07/2009	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
05/07/2009	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
05/07/2009	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
05/07/2009	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Isolated	Minimal harm or potential for actual harm
05/07/2009	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
05/07/2009	Make sure that the attending doctor orders special diets.	Isolated	Minimal harm or potential for actual harm
05/07/2009	Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing.	Isolated	Minimal harm or potential for actual harm
05/07/2009	Make sure that doctors visit residents regularly, as required.	Isolated	Minimal harm or potential for actual harm
05/07/2009	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Isolated	Minimal harm or potential for actual harm
05/07/2009	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
03/20/2008	smoke barrier doors that can resist smoke for at least 20 minutes.	Isolated	Minimal harm or potential for actual harm
03/20/2008	construction that can resist fire for one hour or an approved fire extinguishing system.	Isolated	Minimal harm or potential for actual harm
03/20/2008	exits that are accessible at all times.	Isolated	Minimal harm or potential for actual harm
03/20/2008	an approved installation, maintenance and testing program for fire alarm systems.	Widespread	Potential for minimal harm
03/20/2008	portable fire extinguishers.	Widespread	Potential for minimal harm
03/20/2008	restrictions on the use of highly flammable materials.	Isolated	Minimal harm or potential for actual harm
03/20/2008	proper medical gas storage and administration areas.	Pattern	Minimal harm or potential for actual harm
03/20/2008	fire safety features required by current fire safety codes.	Widespread	Potential for minimal harm
03/20/2008	weekly inspections and monthly testing of generators.	Pattern	Minimal harm or potential for actual harm
03/20/2008	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
03/05/2008	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
03/05/2008	Keep safe, clean and homelike surroundings.	Isolated	Minimal harm or potential for actual harm
03/05/2008	Do an assessment of the resident every year.	Isolated	Minimal harm or potential for actual harm
03/05/2008	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
03/05/2008	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
03/05/2008	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
03/05/2008	Get rid of garbage properly.	Pattern	Potential for minimal harm
03/05/2008	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
03/05/2008	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
03/05/2008	Train all employees on what to do in an emergency.	Pattern	Potential for minimal 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