SAN FRANCISCO NURSING CENTER CA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
12/06/2010	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
12/06/2010	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
12/06/2010	walls or barriers that prevent smoke from passing through and would resist fire for at least one hour.	Isolated	Minimal harm or potential for actual harm
12/06/2010	smoke barrier doors that can resist smoke for at least 20 minutes.	Pattern	Minimal harm or potential for actual harm
12/06/2010	an approved installation, maintenance and testing program for fire alarm systems.	Isolated	Minimal harm or potential for actual harm
12/06/2010	an automatic smoke detection system in all hallways.	Isolated	Minimal harm or potential for actual harm
12/06/2010	properly maintained smoke detectors.	Isolated	Minimal harm or potential for actual harm
12/06/2010	automatic sprinkler systems that have been maintained in working order.	Isolated	Minimal harm or potential for actual harm
12/06/2010	portable fire extinguishers.	Isolated	Minimal harm or potential for actual harm
12/06/2010	heating and ventilation systems that have been properly installed according to the manufacturer's instructions.	Pattern	Minimal harm or potential for actual harm
12/06/2010	properly protected cooking facilities.	Isolated	Minimal harm or potential for actual harm
12/06/2010	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
12/06/2010	back-up procedures in place for a faulty automatic sprinkler system.	Widespread	Potential for minimal harm
12/06/2010	an approved back-up procedure for a faulty fire alarm system.	Widespread	Potential for minimal harm
11/23/2010	Tell the resident completely about his or her health status.	Isolated	Minimal harm or potential for actual harm
11/23/2010	Let each resident choose a personal doctor.	Isolated	Minimal harm or potential for actual harm
11/23/2010	Keep safe, clean and homelike surroundings.	Isolated	Minimal harm or potential for actual harm
11/23/2010	Do a new assessment after any major change in a resident's physical or mental health.	Isolated	Minimal harm or potential for actual harm
11/23/2010	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
11/23/2010	Give proper treatment to residents with feeding tubes to prevent problems (such as aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, nasal-pharyngeal ulcers) and help restore eating skills, if possible.	Isolated	Minimal harm or potential for actual harm
11/23/2010	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
11/23/2010	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
11/23/2010	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
11/23/2010	Give special rehabilitation by skilled workers, when ordered by a doctor.	Isolated	Minimal harm or potential for actual harm
11/23/2010	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
11/23/2010	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
11/23/2010	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
11/25/2009	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
11/25/2009	properly installed electrical wiring and equipment.	Isolated	Minimal harm or potential for actual harm
11/10/2009	Keep adequate and comfortable lighting in all areas.	Isolated	Minimal harm or potential for actual harm
11/10/2009	Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion.	Isolated	Minimal harm or potential for actual harm
11/10/2009	Give proper treatment to residents with feeding tubes to prevent problems (such as aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, nasal-pharyngeal ulcers) and help restore eating skills, if possible.	Isolated	Minimal harm or potential for actual harm
11/10/2009	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
11/10/2009	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
11/10/2009	Provide bedrooms that don't allow residents to see each other when privacy is needed.	Isolated	Minimal harm or potential for actual harm
11/10/2009	Put firmly secured handrails on each side of hallways.	Isolated	Minimal harm or potential for actual harm
11/05/2008	a fire alarm system that can be heard throughout the facility.	Isolated	Minimal harm or potential for actual harm
11/05/2008	properly maintained smoke detectors.	Isolated	Minimal harm or potential for actual harm
11/05/2008	portable fire extinguishers.	Isolated	Minimal harm or potential for actual harm
11/05/2008	properly protected cooking facilities.	Isolated	Minimal harm or potential for actual harm
11/05/2008	proper medical gas storage and administration areas.	Isolated	Minimal harm or potential for actual harm
11/05/2008	fire safety features required by current fire safety codes.	Isolated	Minimal harm or potential for actual harm
10/31/2008	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
10/31/2008	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
10/31/2008	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
10/31/2008	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
10/31/2008	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Isolated	Minimal harm or potential for actual harm
10/31/2008	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	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