OAKHILL SPRINGS CARE CENTER CA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
04/14/2010	smoke barrier doors that can resist smoke for at least 20 minutes.	Pattern	Minimal harm or potential for actual harm
04/14/2010	properly located and lighted "Exit" signs.	Isolated	Minimal harm or potential for actual harm
04/14/2010	posted "No-smoking" signs in areas where smoking is not permitted or did not provide ashtrays where smoking was allowed.	Isolated	Minimal harm or potential for actual harm
03/10/2010	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Potential for minimal harm
03/10/2010	Keep safe, clean and homelike surroundings.	Pattern	Minimal harm or potential for actual harm
03/10/2010	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
03/10/2010	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
03/10/2010	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
06/04/2009	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
06/04/2009	smoke barrier doors that can resist smoke for at least 20 minutes.	Widespread	Minimal harm or potential for actual harm
06/04/2009	record of quarterly fire drills for each shift under varying conditions.	Isolated	Minimal harm or potential for actual harm
06/04/2009	portable fire extinguishers.	Pattern	Minimal harm or potential for actual harm
06/04/2009	properly protected cooking facilities.	Isolated	Minimal harm or potential for actual harm
06/04/2009	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
05/28/2009	Let residents give themselves their drugs if they are able.	Isolated	Minimal harm or potential for actual harm
05/28/2009	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
05/28/2009	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
05/28/2009	Make sure that each resident's nutritional needs were met.	Pattern	Minimal harm or potential for actual harm
05/28/2009	Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	Isolated	Minimal harm or potential for actual harm
05/28/2009	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
05/28/2009	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Isolated	Minimal harm or potential for actual harm
05/28/2009	Make sure that the attending doctor orders special diets.	Isolated	Minimal harm or potential for actual harm
05/28/2009	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Isolated	Minimal harm or potential for actual harm
05/28/2009	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
04/14/2008	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
04/14/2008	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
04/14/2008	Let residents complain without being treated differently or badly.	Isolated	Minimal harm or potential for actual harm
04/14/2008	Provide written records when a resident is transferred or discharged.	Isolated	Minimal harm or potential for actual harm
04/14/2008	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Minimal harm or potential for actual harm
04/14/2008	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
04/14/2008	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
04/14/2008	Keep temperature levels comfortable and safe.	Isolated	Minimal harm or potential for actual harm
04/14/2008	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
04/14/2008	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
04/14/2008	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
04/14/2008	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
04/14/2008	Make sure that the nursing home area is free of dangers that cause accidents.	Widespread	Minimal harm or potential for actual harm
04/14/2008	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
04/14/2008	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
04/14/2008	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
04/14/2008	Develop/implement required procedures for the administration of immunizations.	Widespread	Minimal harm or potential for actual harm
04/14/2008	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
04/14/2008	Provide food in a way that meets a resident's needs.	Isolated	Minimal harm or potential for actual harm
04/14/2008	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
04/14/2008	Get rid of garbage properly.	Pattern	Potential for minimal harm
04/14/2008	Give or get special rehabilitation if in the patient's plan of care.	Pattern	Minimal harm or potential for actual harm
04/14/2008	Give or get dental care for each resident.	Isolated	Minimal harm or potential for actual harm
04/14/2008	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
04/14/2008	Have a program to keep infection from spreading.	Widespread	Minimal harm or potential for actual harm
04/14/2008	Keep all essential equipment working safely.	Widespread	Potential for minimal harm
04/14/2008	1) Set up a group that is legally responsible for writing and setting up policies for leading and running the nursing home; or 2) hire a properly licensed administrator.	Widespread	Minimal harm or potential for actual harm
04/14/2008	Get services outside the nursing home that meet professional standards.	Isolated	Minimal harm or potential for actual harm
04/14/2008	Choose a doctor to be the medical director.	Widespread	Minimal harm or potential for actual harm
04/14/2008	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
04/14/2008	Have a detailed, written plan for disasters and emergencies.	Widespread	Potential for minimal harm
04/14/2008	Set up or keep a group of people to review and ensure quality.	Widespread	Minimal harm or potential for actual harm
04/02/2008	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
04/02/2008	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
04/02/2008	smoke barrier doors that can resist smoke for at least 20 minutes.	Isolated	Minimal harm or potential for actual harm
04/02/2008	construction that can resist fire for one hour or an approved fire extinguishing system.	Isolated	Minimal harm or potential for actual harm
04/02/2008	properly sized and located linen or trash receptacles.	Isolated	Minimal harm or potential for actual harm
04/02/2008	proper medical gas storage and administration areas.	Isolated	Minimal harm or potential for actual harm
04/02/2008	fire safety features required by current fire safety codes.	Pattern	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