NORTHWEST NURSING AND REHAB CENTER MD DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
06/28/2010	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
06/28/2010	exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detectors.	Pattern	Minimal harm or potential for actual harm
06/28/2010	construction that can resist fire for one hour or an approved fire extinguishing system.	Pattern	Minimal harm or potential for actual harm
06/28/2010	proper medical gas storage and administration areas.	Pattern	Minimal harm or potential for actual harm
04/08/2010	Let the resident refuse treatment or refuse to take part in an experiment.	Isolated	Minimal harm or potential for actual harm
04/08/2010	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
04/08/2010	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
04/08/2010	Properly hold, secure and manage each resident's personal money which is deposited with the nursing home.	Widespread	Potential for minimal harm
04/08/2010	Quickly give a resident's personal money to the heads of his or her estate after the resident's death.	Widespread	Potential for minimal harm
04/08/2010	Allow residents to easily see the results of the nursing home's most recent survey.	Widespread	Potential for minimal harm
04/08/2010	Make sure each resident has the right to choose activities, schedules and health care according to his or her interests, assessment, and plan of care.	Isolated	Minimal harm or potential for actual harm
04/08/2010	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
04/08/2010	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
04/08/2010	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Pattern	Minimal harm or potential for actual harm
04/08/2010	Assess the resident when the resident enters the nursing home, in a timely manner.	Isolated	Minimal harm or potential for actual harm
04/08/2010	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
04/08/2010	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.	Pattern	Minimal harm or potential for actual harm
04/08/2010	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
04/08/2010	Give each resident care and services to get or keep the highest quality of life possible.	Pattern	Minimal harm or potential for actual harm
04/08/2010	Make sure that the nursing home area is free of dangers that cause accidents.	Widespread	Potential for minimal harm
04/08/2010	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
04/08/2010	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
04/08/2010	Give or get special rehabilitation if in the patient's plan of care.	Isolated	Minimal harm or potential for actual harm
04/08/2010	Give or get dental care for each resident.	Isolated	Minimal harm or potential for actual harm
04/08/2010	Give or get dental care for each resident.	Isolated	Minimal harm or potential for actual harm
04/08/2010	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Isolated	Minimal harm or potential for actual harm
04/08/2010	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
04/08/2010	Be designed, built, equipped, or well kept to protect the health and safety of residents, workers, and the public.	Widespread	Potential for minimal harm
04/08/2010	Be administered in a way that leads to the highest possible level of well being for each resident.	Isolated	Minimal harm or potential for actual harm
04/08/2010	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
10/22/2009	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
10/22/2009	properly constructed windows in hallway walls or doors.	Pattern	Minimal harm or potential for actual harm
10/22/2009	exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detectors.	Pattern	Minimal harm or potential for actual harm
10/22/2009	construction that can resist fire for one hour or an approved fire extinguishing system.	Pattern	Minimal harm or potential for actual harm
10/22/2009	properly located and lighted "Exit" signs.	Isolated	Minimal harm or potential for actual harm
10/22/2009	portable fire extinguishers.	Isolated	Minimal harm or potential for actual harm
10/22/2009	proper medical gas storage and administration areas.	Pattern	Minimal harm or potential for actual harm
02/11/2009	Let the appropriate people see and talk to each resident.	Isolated	Minimal harm or potential for actual harm
02/11/2009	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
02/11/2009	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
02/11/2009	Make sure there is a program to prevent/deal with mice, insects, or other pests.	Widespread	Minimal harm or potential for actual harm
02/11/2009	Follow all laws and professional standards.	Pattern	Minimal harm or potential for actual harm
02/29/2008	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
02/29/2008	exit stairways and towers that are smoke proof.	Isolated	Minimal harm or potential for actual harm
02/29/2008	heating and ventilation systems that have been properly installed according to the manufacturer's instructions.	Pattern	Minimal harm or potential for actual harm
02/29/2008	restrictions on the use of portable space heaters.	Isolated	Minimal harm or potential for actual harm
02/29/2008	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
01/10/2008	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
01/10/2008	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.	Pattern	Minimal harm or potential for actual harm
01/10/2008	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
01/10/2008	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Actual harm
01/10/2008	Give the right treatment and services to residents who have mental or social problems adjusting.	Isolated	Minimal harm or potential for actual harm
01/10/2008	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
01/10/2008	Make sure that residents are safe from serious medication errors.	Pattern	Minimal harm or potential for actual harm
01/10/2008	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
01/10/2008	Make sure that a doctor approves a resident's admission in writing and that each resident has a doctor.	Isolated	Minimal harm or potential for actual harm
01/10/2008	Have a program to keep infection from spreading.	Widespread	Minimal harm or potential for actual harm
01/10/2008	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
01/10/2008	Quickly tell the resident's doctor the results of lab tests.	Isolated	Minimal harm or potential for actual harm
01/10/2008	Keep accurate and appropriate medical records.	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