PIONEER HOUSE CA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
10/12/2010	proper medical gas storage and administration areas.	Isolated	Minimal harm or potential for actual harm
10/12/2010	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
10/12/2010	approved construction type or materials.	Pattern	Minimal harm or potential for actual harm
10/12/2010	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
10/12/2010	construction that can resist fire for one hour or an approved fire extinguishing system.	Isolated	Minimal harm or potential for actual harm
10/12/2010	emergency lighting that can last at least 1 1/2 hours.	Isolated	Minimal harm or potential for actual harm
10/12/2010	properly located and lighted "Exit" signs.	Isolated	Minimal harm or potential for actual harm
10/12/2010	did not have a written emergency evacuation plan.	Widespread	Potential for minimal harm
10/12/2010	a fire alarm system that can be heard throughout the facility.	Pattern	Minimal harm or potential for actual harm
10/12/2010	exits that are free from obstructions and can be used at all times.	Isolated	Minimal harm or potential for actual harm
10/08/2010	Properly hold, secure and manage each resident's personal money which is deposited with the nursing home.	Isolated	Minimal harm or potential for actual harm
10/08/2010	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
10/08/2010	Listen to the resident or family groups or act on their complaints or suggestions.	Isolated	Minimal harm or potential for actual harm
10/08/2010	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
10/08/2010	Keep assessments completed in the preceding 15 months in the resident's active record.	Pattern	Minimal harm or potential for actual harm
10/08/2010	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
10/08/2010	Make sure that all needed doctor visits are made personally by a doctor, as required.	Isolated	Minimal harm or potential for actual harm
10/08/2010	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
10/08/2010	Make sure that a working call system is available in each resident's room or bathroom and bathing area.	Pattern	Minimal harm or potential for actual harm
10/08/2010	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Widespread	Minimal harm or potential for actual harm
10/08/2010	Put firmly secured handrails on each side of hallways.	Pattern	Minimal harm or potential for actual harm
10/08/2010	Hire nurse aides who have shown that they are skilled and care for residents safely on-the-job.	Widespread	Minimal harm or potential for actual harm
10/08/2010	Get proof that a nurse aide has the training and skills that the State requires.	Widespread	Minimal harm or potential for actual harm
10/08/2010	Get services outside the nursing home that meet professional standards.	Isolated	Minimal harm or potential for actual harm
10/08/2010	Have a detailed, written plan for disasters and emergencies.	Widespread	Minimal harm or potential for actual harm
10/08/2010	Set up or keep a group of people to review and ensure quality.	Widespread	Minimal harm or potential for actual harm
08/28/2009	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
08/28/2009	record of quarterly fire drills for each shift under varying conditions.	Isolated	Minimal harm or potential for actual harm
08/28/2009	a fire alarm system that can be heard throughout the facility.	Pattern	Minimal harm or potential for actual harm
08/28/2009	proper medical gas storage and administration areas.	Isolated	Minimal harm or potential for actual harm
08/28/2009	weekly inspections and monthly testing of generators.	Pattern	Minimal harm or potential for actual harm
08/28/2009	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
08/20/2009	Keep each resident free from physical restraints, unless needed for medical treatment.	Pattern	Minimal harm or potential for actual harm
08/20/2009	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
08/20/2009	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Isolated	Minimal harm or potential for actual harm
08/20/2009	post nurse staffing information.	Widespread	Potential for minimal harm
08/20/2009	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
08/20/2009	Give or get dental care for each resident.	Isolated	Minimal harm or potential for actual harm
08/20/2009	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
08/20/2009	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
08/20/2009	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Isolated	Minimal harm or potential for actual harm
08/20/2009	Train all employees on what to do in an emergency.	Pattern	Minimal harm or potential for actual harm
07/29/2008	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
07/29/2008	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
07/29/2008	a fire alarm system that can be heard throughout the facility.	Isolated	Minimal harm or potential for actual harm
07/29/2008	an approved automatic sprinkler system connected to the fire alarm system.	Widespread	Minimal harm or potential for actual harm
07/29/2008	properly installed electrical wiring and equipment.	Pattern	Potential for minimal harm
07/29/2008	back-up procedures in place for a faulty automatic sprinkler system.	Widespread	Potential for minimal harm
07/29/2008	an approved back-up procedure for a faulty fire alarm system.	Widespread	Potential for minimal harm
07/24/2008	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
07/24/2008	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Isolated	Minimal harm or potential for actual harm
07/24/2008	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
07/24/2008	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Isolated	Minimal harm or potential for actual harm
07/24/2008	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
07/24/2008	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
07/24/2008	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
07/24/2008	Train all employees on what to do in an emergency.	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