PALM GARDEN OF VERO BEACH FL DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
11/09/2010	approved construction type or materials.	Widespread	Minimal harm or potential for actual harm
11/09/2010	corridor and hallway doors that block smoke.	Widespread	Minimal harm or potential for actual harm
11/09/2010	walls or barriers that prevent smoke from passing through and would resist fire for at least one hour.	Widespread	Minimal harm or potential for actual harm
11/09/2010	exits that are accessible at all times.	Widespread	Minimal harm or potential for actual harm
11/09/2010	emergency lighting that can last at least 1 1/2 hours.	Widespread	Minimal harm or potential for actual harm
11/09/2010	properly located and lighted "Exit" signs.	Widespread	Minimal harm or potential for actual harm
11/09/2010	record of quarterly fire drills for each shift under varying conditions.	Widespread	Minimal harm or potential for actual harm
11/09/2010	a fire alarm system that can be heard throughout the facility.	Widespread	Minimal harm or potential for actual harm
11/09/2010	an approved automatic sprinkler system connected to the fire alarm system.	Widespread	Minimal harm or potential for actual harm
11/09/2010	automatic sprinkler systems that have been maintained in working order.	Widespread	Minimal harm or potential for actual harm
11/09/2010	portable fire extinguishers.	Widespread	Minimal harm or potential for actual harm
11/09/2010	heating and ventilation systems that have been properly installed according to the manufacturer's instructions.	Widespread	Minimal harm or potential for actual harm
11/09/2010	proper medical gas storage and administration areas.	Pattern	Minimal harm or potential for actual harm
11/09/2010	properly installed electrical wiring and equipment.	Widespread	Minimal harm or potential for actual harm
11/05/2010	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
11/05/2010	Try to resolve each resident's complaints quickly.	Isolated	Minimal harm or potential for actual harm
11/05/2010	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
11/05/2010	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.	Pattern	Minimal harm or potential for actual harm
11/05/2010	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
11/05/2010	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
11/05/2010	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
11/05/2010	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
11/05/2010	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
11/05/2010	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
11/05/2010	Provide food in a way that meets a resident's needs.	Pattern	Minimal harm or potential for actual harm
11/05/2010	Offer other nutritional food to each resident who will not eat the food served.	Pattern	Minimal harm or potential for actual harm
11/05/2010	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
11/05/2010	Give or get dental care for each resident.	Isolated	Minimal harm or potential for actual harm
11/05/2010	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
11/05/2010	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
11/05/2010	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
09/18/2009	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
09/18/2009	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
09/18/2009	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
09/18/2009	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
09/18/2009	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
09/18/2009	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
09/18/2009	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
09/18/2009	Make sure that the attending doctor orders special diets.	Isolated	Minimal harm or potential for actual harm
09/18/2009	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	Minimal harm or potential for actual harm
09/18/2009	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
09/18/2009	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Isolated	Minimal harm or potential for actual harm
09/18/2009	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
09/18/2009	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.	Pattern	Minimal harm or potential for actual harm
09/15/2009	smoke barrier doors that can resist smoke for at least 20 minutes.	Isolated	Minimal harm or potential for actual harm
09/15/2009	record of quarterly fire drills for each shift under varying conditions.	Widespread	Minimal harm or potential for actual harm
09/15/2009	properly protected cooking facilities.	Widespread	Minimal harm or potential for actual harm
09/15/2009	properly installed electrical wiring and equipment.	Widespread	Minimal harm or potential for actual harm
09/11/2008	Try to resolve each resident's complaints quickly.	Isolated	Minimal harm or potential for actual harm
09/11/2008	Allow residents to easily see the results of the nursing home's most recent survey.	Widespread	Potential for minimal harm
09/11/2008	Let residents give themselves their drugs if they are able.	Isolated	Minimal harm or potential for actual harm
09/11/2008	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
09/11/2008	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
09/11/2008	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
09/11/2008	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
09/11/2008	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
09/11/2008	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
09/11/2008	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
09/11/2008	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
09/11/2008	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
09/11/2008	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.	Pattern	Minimal harm or potential for actual harm
09/11/2008	Develop/implement required procedures for the administration of immunizations.	Isolated	Minimal harm or potential for actual harm
09/11/2008	post nurse staffing information.	Widespread	Potential for minimal harm
09/11/2008	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
09/11/2008	Make sure that the attending doctor orders special diets.	Isolated	Minimal harm or potential for actual harm
09/11/2008	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
09/11/2008	Get rid of garbage properly.	Widespread	Minimal harm or potential for actual harm
09/11/2008	Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing.	Isolated	Minimal harm or potential for actual harm
09/11/2008	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Isolated	Minimal harm or potential for actual harm
09/11/2008	Make sure each resident has 1) at least one window to the outside in a room; 2) a room at or above ground level; 3) an adequate bed; 4) furniture that meets the resident's needs; or 5) enough closet space.	Isolated	Minimal harm or potential for actual harm
09/11/2008	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.	Pattern	Minimal harm or potential for actual harm
09/11/2008	Choose a doctor to be the medical director.	Isolated	Minimal harm or potential for actual harm
09/11/2008	Give or get lab tests to meet the needs of residents.	Isolated	Minimal harm or potential for actual harm
09/09/2008	record of quarterly fire drills for each shift under varying conditions.	Widespread	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