MULTI-MEDICAL CENTER MD DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
08/04/2010	corridors that are separated from common areas by walls constructed to limit the passage of smoke.	Isolated	Minimal harm or potential for actual harm
08/04/2010	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
08/04/2010	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
07/19/2010	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
07/19/2010	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
07/19/2010	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
07/19/2010	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
07/19/2010	Be designed, built, equipped, or well kept to protect the health and safety of residents, workers, and the public.	Isolated	Minimal harm or potential for actual harm
06/10/2009	exit stairways and towers that are smoke proof.	Isolated	Minimal harm or potential for actual harm
06/10/2009	properly constructed linen or trash chutes.	Pattern	Minimal harm or potential for actual harm
06/10/2009	proper power supply for life support equipment.	Pattern	Minimal harm or potential for actual harm
06/10/2009	properly protected cooking facilities.	Isolated	Minimal harm or potential for actual harm
06/10/2009	proper backup exit lighting.	Pattern	Minimal harm or potential for actual harm
05/22/2009	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
05/22/2009	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
05/22/2009	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Pattern	Potential for minimal harm
05/22/2009	Give professional services that meet a professional standard of quality.	Pattern	Potential for minimal harm
05/22/2009	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	Minimal harm or potential for actual harm
05/22/2009	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Actual harm
05/22/2009	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
05/22/2009	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
05/22/2009	Have enough outside airflow.	Widespread	Potential for minimal harm
05/22/2009	Have a detailed, written plan for disasters and emergencies.	Widespread	Potential for minimal harm
06/04/2008	construction that can resist fire for one hour or an approved fire extinguishing system.	Pattern	Potential for minimal harm
06/04/2008	exit stairways and towers that are smoke proof.	Pattern	Minimal harm or potential for actual harm
06/04/2008	an approved automatic sprinkler system connected to the fire alarm system.	Pattern	Minimal harm or potential for actual harm
06/04/2008	properly protected cooking facilities.	Pattern	Minimal harm or potential for actual harm
06/04/2008	properly constructed linen or trash chutes.	Pattern	Minimal harm or potential for actual harm
04/30/2008	Keep adequate and comfortable lighting in all areas.	Widespread	Potential for minimal harm
04/30/2008	Do an assessment of the resident every year.	Isolated	Minimal harm or potential for actual harm
04/30/2008	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
04/30/2008	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
04/30/2008	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
04/30/2008	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
04/30/2008	Develop/implement required procedures for the administration of immunizations.	Isolated	Minimal harm or potential for actual harm
04/30/2008	Make sure that residents are well nourished.	Isolated	Minimal harm or potential for actual harm
04/30/2008	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Potential for minimal harm
04/30/2008	Provide food in a way that meets a resident's needs.	Isolated	Minimal harm or potential for actual harm
04/30/2008	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
04/30/2008	Get rid of garbage properly.	Isolated	Minimal harm or potential for actual harm
04/30/2008	Have drugs and other similar products available, which are needed every day and in emergencies, and give them out properly.	Isolated	Minimal harm or potential for actual harm
04/30/2008	Properly mark drugs and other similar products.	Widespread	Potential for minimal harm
04/30/2008	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
04/30/2008	Follow all laws and professional standards.	Isolated	Minimal harm or potential for actual harm
04/30/2008	Give or get lab tests to meet the needs of residents.	Isolated	Minimal harm or potential for actual harm
04/30/2008	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
04/30/2008	Set up or keep a group of people to review and ensure quality.	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