NORTH LAKE REHABILITATION AND HEALTH CENTER FL DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
02/03/2011	Tell each resident who can get Medicaid benefits about 1) which items and services Medicaid covers and which the resident must pay for; or 2) how to apply for Medicaid, along with the names and addresses of State groups that can help.	Widespread	Potential for minimal harm
02/03/2011	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
02/03/2011	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Isolated	Minimal harm or potential for actual harm
02/03/2011	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
02/03/2011	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
02/03/2011	Keep all essential equipment working safely.	Pattern	Minimal harm or potential for actual harm
02/03/2011	Make sure that a working call system is available in each resident's room or bathroom and bathing area.	Isolated	Minimal harm or potential for actual harm
02/03/2011	Have enough backup water supply for important areas of the nursing home.	Widespread	Minimal harm or potential for actual harm
02/03/2011	Put firmly secured handrails on each side of hallways.	Isolated	Minimal harm or potential for actual harm
01/31/2011	exits that are accessible at all times.	Isolated	Minimal harm or potential for actual harm
01/31/2011	record of quarterly fire drills for each shift under varying conditions.	Isolated	Minimal harm or potential for actual harm
01/31/2011	automatic sprinkler systems that have been maintained in working order.	Isolated	Minimal harm or potential for actual harm
01/31/2011	portable fire extinguishers.	Isolated	Minimal harm or potential for actual harm
01/31/2011	properly protected cooking facilities.	Isolated	Minimal harm or potential for actual harm
01/31/2011	proper construction of ducts through walls designed to prevent smoke passage.	Isolated	Minimal harm or potential for actual harm
01/31/2011	weekly inspections and monthly testing of generators.	Isolated	Minimal harm or potential for actual harm
12/11/2009	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
12/11/2009	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Minimal harm or potential for actual harm
12/11/2009	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
12/11/2009	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
12/11/2009	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
12/11/2009	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
12/11/2009	Make sure that the attending doctor orders special diets.	Isolated	Minimal harm or potential for actual harm
12/11/2009	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
12/07/2009	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
11/14/2008	Tell each resident who can get Medicaid benefits about 1) which items and services Medicaid covers and which the resident must pay for; or 2) how to apply for Medicaid, along with the names and addresses of State groups that can help.	Widespread	Potential for minimal harm
11/14/2008	Properly hold, secure and manage each resident's personal money which is deposited with the nursing home.	Isolated	Actual harm
11/14/2008	Have a private telephone available for use.	Pattern	Minimal harm or potential for actual harm
11/14/2008	Let residents give themselves their drugs if they are able.	Isolated	Minimal harm or potential for actual harm
11/14/2008	Protect residents from mistreatment, neglect, and/or theft of personal property.	Isolated	Actual harm
11/14/2008	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Isolated	Actual harm
11/14/2008	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
11/14/2008	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
11/14/2008	Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.	Isolated	Minimal harm or potential for actual harm
11/14/2008	Make sure that each resident gets help to keep vision and hearing.	Isolated	Minimal harm or potential for actual harm
11/14/2008	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
11/14/2008	Develop/implement required procedures for the administration of immunizations.	Isolated	Minimal harm or potential for actual harm
11/14/2008	Make sure that residents are well nourished.	Widespread	Potential for minimal harm
11/14/2008	Be administered in a way that leads to the highest possible level of well being for each resident.	Isolated	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