SANTA CRUZ SKILLED NURSING CENTER CA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
03/24/2010	approved construction type or materials.	Pattern	Minimal harm or potential for actual harm
03/24/2010	corridors that are separated from common areas by walls constructed to limit the passage of smoke.	Pattern	Minimal harm or potential for actual harm
03/24/2010	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
03/24/2010	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
03/24/2010	automatic sprinkler systems that have been maintained in working order.	Isolated	Minimal harm or potential for actual harm
03/24/2010	portable fire extinguishers.	Pattern	Minimal harm or potential for actual harm
03/24/2010	restrictions on the use of flammable curtains.	Pattern	Minimal harm or potential for actual harm
03/24/2010	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
03/22/2010	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
03/22/2010	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
03/22/2010	Provide rooms that are big enough for each resident.	Pattern	Potential for minimal harm
03/22/2010	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
09/24/2009	signs that state that exit doors are to be kept closed.	Isolated	Minimal harm or potential for actual harm
09/24/2009	construction that can resist fire for one hour or an approved fire extinguishing system.	Isolated	Minimal harm or potential for actual harm
09/24/2009	an approved installation, maintenance and testing program for fire alarm systems.	Pattern	Minimal harm or potential for actual harm
09/24/2009	properly protected cooking facilities.	Widespread	Minimal harm or potential for actual harm
09/24/2009	properly constructed linen or trash chutes.	Pattern	Minimal harm or potential for actual harm
09/23/2009	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.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Keep each resident's personal and medical records private and confidential.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Let residents give themselves their drugs if they are able.	Isolated	Minimal harm or potential for actual harm
09/23/2009	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
09/23/2009	Provide care for each resident in a way that keeps or builds the resident's quality of life.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Keep safe, clean and homelike surroundings.	Pattern	Minimal harm or potential for actual harm
09/23/2009	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
09/23/2009	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
09/23/2009	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Provide a final summary of the resident's health status and a summary of the resident's stay, when the resident is ready to leave the nursing home.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Develop a plan with the resident and family for the resident's care after leaving the nursing home.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
09/23/2009	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Get rid of garbage properly.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Keep all essential equipment working safely.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Provide rooms that are big enough for each resident.	Pattern	Minimal harm or potential for actual harm
09/23/2009	Give or get lab tests to meet the needs of residents.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Quickly tell the resident's doctor the results of lab tests.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Keep complete, dated lab records in the resident's file.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
09/23/2009	Have a detailed, written plan for disasters and emergencies.	Isolated	Minimal harm or potential for actual harm
04/08/2009	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
04/08/2009	signs that state that exit doors are to be kept closed.	Isolated	Minimal harm or potential for actual harm
04/08/2009	an approved installation, maintenance and testing program for fire alarm systems.	Isolated	Minimal harm or potential for actual harm
04/08/2009	properly maintained smoke detectors.	Widespread	Minimal harm or potential for actual harm
04/08/2009	properly protected cooking facilities.	Isolated	Minimal harm or potential for actual harm
04/08/2009	proper medical gas storage and administration areas.	Isolated	Minimal harm or potential for actual harm
03/25/2009	Give the resident's legal representative the same rights as the resident.	Isolated	Minimal harm or potential for actual harm
03/25/2009	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
03/25/2009	Keep adequate and comfortable lighting in all areas.	Isolated	Minimal harm or potential for actual harm
03/25/2009	Keep temperature levels comfortable and safe.	Isolated	Minimal harm or potential for actual harm
03/25/2009	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
03/25/2009	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
03/25/2009	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
03/25/2009	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Immediate jeopardy to resident health or safety
03/25/2009	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
03/25/2009	Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing.	Pattern	Potential for minimal harm
03/25/2009	Have drugs and other similar products available, which are needed every day and in emergencies, and give them out properly.	Pattern	Potential for minimal harm
03/25/2009	Properly mark drugs and other similar products.	Pattern	Minimal harm or potential for actual harm
03/25/2009	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
03/25/2009	Keep all essential equipment working safely.	Isolated	Minimal harm or potential for actual harm
03/25/2009	Provide bedrooms that don't allow residents to see each other when privacy is needed.	Isolated	Minimal harm or potential for actual harm
03/25/2009	Keep complete, dated lab records in the resident's file.	Isolated	Minimal harm or potential for actual harm
03/25/2009	Keep accurate and appropriate medical records.	Pattern	Potential for minimal 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