MORTON VILLA CARE CENTER IL DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
01/28/2010	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
01/28/2010	Provide proof that all residents' personal money which is deposited with the nursing home, is secure.	Pattern	Minimal harm or potential for actual harm
01/28/2010	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
01/28/2010	1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents.	Isolated	Minimal harm or potential for actual harm
01/28/2010	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
01/28/2010	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
01/28/2010	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
01/28/2010	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Actual harm
01/28/2010	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Actual harm
01/28/2010	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Isolated	Minimal harm or potential for actual harm
01/28/2010	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
01/28/2010	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
01/21/2010	fire-resistant interior walls.	Pattern	Minimal harm or potential for actual harm
01/21/2010	construction that can resist fire for one hour or an approved fire extinguishing system.	Pattern	Minimal harm or potential for actual harm
01/21/2010	exits that are accessible at all times.	Isolated	Minimal harm or potential for actual harm
01/21/2010	an approved automatic sprinkler system connected to the fire alarm system.	Widespread	Minimal harm or potential for actual harm
01/21/2010	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
03/13/2009	construction that can resist fire for one hour or an approved fire extinguishing system.	Pattern	Minimal harm or potential for actual harm
03/13/2009	exits that are accessible at all times.	Pattern	Minimal harm or potential for actual harm
03/13/2009	proper backup exit lighting.	Pattern	Minimal harm or potential for actual harm
03/13/2009	did not have a written emergency evacuation plan.	Widespread	Minimal harm or potential for actual harm
03/13/2009	record of quarterly fire drills for each shift under varying conditions.	Widespread	Potential for minimal harm
03/13/2009	automatic sprinkler systems that have been maintained in working order.	Widespread	Minimal harm or potential for actual harm
03/13/2009	exits that are free from obstructions and can be used at all times.	Pattern	Minimal harm or potential for actual harm
03/13/2009	proper medical gas storage and administration areas.	Pattern	Minimal harm or potential for actual harm
03/13/2009	proper fire barriers, ventilation and signs for the transport of oxygen.	Pattern	Minimal harm or potential for actual harm
03/13/2009	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
03/13/2009	properly installed hallway dispensers for alcohol-based hand rub.	Widespread	Minimal harm or potential for actual harm
02/05/2009	Keep each resident's personal and medical records private and confidential.	Pattern	Potential for minimal harm
02/05/2009	Keep each resident free from physical restraints, unless needed for medical treatment.	Pattern	Minimal harm or potential for actual harm
02/05/2009	Protect residents from mistreatment, neglect, and/or theft of personal property.	Isolated	Actual harm
02/05/2009	1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents.	Isolated	Minimal harm or potential for actual harm
02/05/2009	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
02/05/2009	Provide services to meet the needs and preferences of each resident.	Pattern	Minimal harm or potential for actual harm
02/05/2009	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Pattern	Minimal harm or potential for actual harm
02/05/2009	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
02/05/2009	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
02/05/2009	Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.	Pattern	Minimal harm or potential for actual harm
02/05/2009	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Pattern	Minimal harm or potential for actual harm
02/05/2009	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
02/05/2009	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	Actual harm
02/05/2009	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Actual harm
02/05/2009	Make sure that each resident's nutritional needs were met.	Pattern	Minimal harm or potential for actual harm
02/05/2009	Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	Pattern	Minimal harm or potential for actual harm
02/05/2009	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
02/05/2009	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
02/05/2009	Have enough nurses to care for every resident in a way that maximizes the resident's well being.	Widespread	Minimal harm or potential for actual harm
02/05/2009	Use a registered nurse at least 8 hours a day, 7 days a week.	Pattern	Minimal harm or potential for actual harm
02/05/2009	post nurse staffing information.	Widespread	Potential for minimal harm
02/05/2009	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Isolated	Minimal harm or potential for actual harm
02/05/2009	1) Provide 3 meals daily at regular times; or 2) serve breakfast within 14 hours after dinner; or 3) offer a snack at bedtime each day.	Pattern	Potential for minimal harm
02/05/2009	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
02/05/2009	Give or get special rehabilitation if in the patient's plan of care.	Isolated	Minimal harm or potential for actual harm
02/05/2009	Have a program to keep infection from spreading.	Widespread	Minimal harm or potential for actual harm
02/05/2009	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
12/06/2007	corridors that are separated from common areas by walls constructed to limit the passage of smoke.	Widespread	Minimal harm or potential for actual harm
12/06/2007	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
12/06/2007	exits that are accessible at all times.	Widespread	Minimal harm or potential for actual harm
12/06/2007	record of quarterly fire drills for each shift under varying conditions.	Widespread	Minimal harm or potential for actual harm
12/06/2007	properly maintained smoke detectors.	Widespread	Minimal harm or potential for actual harm
12/06/2007	an approved automatic sprinkler system connected to the fire alarm system.	Pattern	Minimal harm or potential for actual harm
12/06/2007	automatic sprinkler systems that have been maintained in working order.	Widespread	Minimal harm or potential for actual harm
12/06/2007	have an adequate water supply for the sprinkler system.	Widespread	Minimal harm or potential for actual harm
12/06/2007	properly protected cooking facilities.	Pattern	Minimal harm or potential for actual harm
12/06/2007	proper fire barriers, ventilation and signs for the transport of oxygen.	Pattern	Minimal harm or potential for actual harm
12/05/2007	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.	Pattern	Minimal harm or potential for actual harm
12/05/2007	Give each resident care and services to get or keep the highest quality of life possible.	Pattern	Minimal harm or potential for actual harm
12/05/2007	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
12/05/2007	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
12/05/2007	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
12/05/2007	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
12/05/2007	Give each resident enough fluids to keep them healthy and prevent dehydration.	Pattern	Minimal harm or potential for actual harm
12/05/2007	Provide special eating equipment and utensils for each resident who needs them.	Isolated	Minimal harm or potential for actual harm
12/05/2007	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
12/05/2007	Use properly trained paid feeding assistants, provide licensed nursing supervision of the feeding assistants, or properly monitor the feeding of its residents.	Isolated	Minimal harm or potential for actual harm
12/05/2007	Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing.	Pattern	Potential for minimal harm
12/05/2007	Properly mark drugs and other similar products.	Pattern	Minimal harm or potential for actual harm
12/05/2007	Keep all essential equipment working safely.	Isolated	Minimal harm or potential for actual harm
12/05/2007	Provide at least one room to use as a dining room and for activities, that is a good size, with good lighting, airflow and furniture.	Isolated	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