RIDGECREST HEALTHCARE CENTER CA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
07/12/2010	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
07/12/2010	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
07/12/2010	exits that are accessible at all times.	Isolated	Minimal harm or potential for actual harm
07/12/2010	an approved installation, maintenance and testing program for fire alarm systems.	Pattern	Minimal harm or potential for actual harm
07/12/2010	properly maintained smoke detectors.	Pattern	Minimal harm or potential for actual harm
07/12/2010	automatic sprinkler systems that have been maintained in working order.	Widespread	Minimal harm or potential for actual harm
07/12/2010	portable fire extinguishers.	Isolated	Minimal harm or potential for actual harm
07/12/2010	heating and ventilation systems that have been properly installed according to the manufacturer's instructions.	Pattern	Minimal harm or potential for actual harm
07/12/2010	properly protected cooking facilities.	Isolated	Minimal harm or potential for actual harm
07/12/2010	fire safety features required by current fire safety codes.	Widespread	Potential for minimal harm
07/12/2010	weekly inspections and monthly testing of generators.	Widespread	Minimal harm or potential for actual harm
07/12/2010	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
07/12/2010	an approved back-up procedure for a faulty fire alarm system.	Widespread	Potential for minimal harm
06/18/2010	Allow residents to easily see the results of the nursing home's most recent survey.	Pattern	Potential for minimal harm
06/18/2010	Protect each resident from all abuse, physical punishment, and being separated from others.	Pattern	Immediate jeopardy to resident health or safety
06/18/2010	Protect residents from mistreatment, neglect, and/or theft of personal property.	Pattern	Immediate jeopardy to resident health or safety
06/18/2010	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	Immediate jeopardy to resident health or safety
06/18/2010	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Immediate jeopardy to resident health or safety
06/18/2010	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Actual harm
06/18/2010	Give enough notice to the resident before changing the resident's room or roommate.	Isolated	Minimal harm or potential for actual harm
06/18/2010	Provide activities to meet the needs of each resident.	Pattern	Potential for minimal harm
06/18/2010	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Isolated	Actual harm
06/18/2010	Provide needed housekeeping and maintenance.	Isolated	Minimal harm or potential for actual harm
06/18/2010	Keep temperature levels comfortable and safe.	Pattern	Minimal harm or potential for actual harm
06/18/2010	Keep sound levels comfortable.	Pattern	Minimal harm or potential for actual harm
06/18/2010	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
06/18/2010	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
06/18/2010	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
06/18/2010	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
06/18/2010	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
06/18/2010	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
06/18/2010	Develop/implement required procedures for the administration of immunizations.	Isolated	Minimal harm or potential for actual harm
06/18/2010	Provide special eating equipment and utensils for each resident who needs them.	Isolated	Minimal harm or potential for actual harm
06/18/2010	Give or get dental care for each resident.	Isolated	Minimal harm or potential for actual harm
06/18/2010	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
06/18/2010	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Minimal harm or potential for actual harm
08/25/2009	a fire alarm system that can be heard throughout the facility.	Widespread	Minimal harm or potential for actual harm
08/25/2009	properly maintained smoke detectors.	Pattern	Minimal harm or potential for actual harm
08/25/2009	automatic sprinkler systems that have been maintained in working order.	Widespread	Minimal harm or potential for actual harm
08/25/2009	exits that are free from obstructions and can be used at all times.	Isolated	Minimal harm or potential for actual harm
08/25/2009	weekly inspections and monthly testing of generators.	Pattern	Minimal harm or potential for actual harm
08/25/2009	construction that can resist fire for one hour or an approved fire extinguishing system.	Isolated	Minimal harm or potential for actual harm
08/25/2009	record of quarterly fire drills for each shift under varying conditions.	Pattern	Minimal harm or potential for actual harm
08/25/2009	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
08/20/2009	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
08/20/2009	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
08/20/2009	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
08/20/2009	Provide a tasty and well-balanced diet that meets the nutritional needs of each resident.	Pattern	Minimal harm or potential for actual harm
08/20/2009	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
08/20/2009	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Isolated	Minimal harm or potential for actual harm
08/20/2009	Make sure that nurse aides show they have the skills to be able to care for residents.	Widespread	Potential for minimal harm
09/30/2008	walls or barriers that prevent smoke from passing through and would resist fire for at least one hour.	Pattern	Minimal harm or potential for actual harm
09/30/2008	construction that can resist fire for one hour or an approved fire extinguishing system.	Isolated	Minimal harm or potential for actual harm
09/30/2008	exits that are accessible at all times.	Isolated	Minimal harm or potential for actual harm
09/30/2008	properly located and lighted "Exit" signs.	Isolated	Minimal harm or potential for actual harm
09/30/2008	automatic sprinkler systems that have been maintained in working order.	Isolated	Minimal harm or potential for actual harm
09/30/2008	exits that are free from obstructions and can be used at all times.	Isolated	Minimal harm or potential for actual harm
09/30/2008	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
09/26/2008	Set up or keep a group of people to review and ensure quality.	Widespread	Minimal harm or potential for actual harm
09/26/2008	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
09/26/2008	Make sure that each residents' abilities to take care of themselves does not lessen, unless a change cannot be avoided.	Isolated	Minimal harm or potential for actual harm
09/26/2008	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
09/26/2008	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
09/26/2008	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.	Isolated	Minimal harm or potential for actual harm
09/26/2008	Develop/implement required procedures for the administration of immunizations.	Widespread	Minimal harm or potential for actual harm
09/26/2008	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
09/26/2008	Get rid of garbage properly.	Pattern	Potential for minimal harm
09/26/2008	Give or get special rehabilitation if in the patient's plan of care.	Isolated	Minimal harm or potential for actual harm
09/26/2008	Properly mark drugs and other similar products.	Pattern	Potential for minimal harm
09/26/2008	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
09/26/2008	Be designed, built, equipped, or well kept to protect the health and safety of residents, workers, and the public.	Pattern	Potential for minimal harm
09/26/2008	Follow all laws and professional standards.	Pattern	Potential for minimal harm
09/26/2008	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
09/26/2008	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
09/26/2008	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
09/26/2008	Keep safe, clean and homelike surroundings.	Isolated	Minimal harm or potential for actual harm
09/26/2008	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
09/26/2008	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Pattern	Potential for minimal harm
09/26/2008	Give professional services that meet a professional standard of quality.	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