URBANDALE HEALTH CARE CENTER IA DEFICIENCY REPORT

	Nursing Home Deficiency Report current as of November 25, 2009
Date	Deficiency	Scope	Level of Harm
11/01/2010	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.	Pattern	Potential for minimal harm
11/01/2010	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
11/01/2010	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
11/01/2010	Give professional services that follow each resident's written care plan.	Pattern	Minimal harm or potential for actual harm
11/01/2010	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
11/01/2010	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
11/01/2010	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
11/01/2010	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
11/01/2010	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
11/01/2010	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
11/01/2010	Properly mark drugs and other similar products.	Pattern	Potential for minimal harm
11/01/2010	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
10/26/2010	approved construction type or materials.	Isolated	Minimal harm or potential for actual harm
10/26/2010	corridors that are separated from common areas by walls constructed to limit the passage of smoke.	Isolated	Minimal harm or potential for actual harm
10/26/2010	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
10/26/2010	record of quarterly fire drills for each shift under varying conditions.	Isolated	Minimal harm or potential for actual harm
10/26/2010	automatic sprinkler systems that have been maintained in working order.	Widespread	Minimal harm or potential for actual harm
10/26/2010	portable fire extinguishers.	Isolated	Minimal harm or potential for actual harm
10/26/2010	properly protected cooking facilities.	Isolated	Minimal harm or potential for actual harm
03/11/2010	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.	Pattern	Potential for minimal harm
03/11/2010	Keep safe, clean and homelike surroundings.	Widespread	Potential for minimal harm
03/11/2010	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
03/11/2010	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Pattern	Minimal harm or potential for actual harm
03/11/2010	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Actual harm
03/11/2010	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
03/11/2010	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
03/11/2010	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
03/11/2010	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
03/11/2010	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Widespread	Minimal harm or potential for actual harm
03/11/2010	approved construction type or materials.	Pattern	Minimal harm or potential for actual harm
03/11/2010	corridor and hallway doors that block smoke.	Pattern	Minimal harm or potential for actual harm
03/11/2010	smoke barrier doors that can resist smoke for at least 20 minutes.	Pattern	Minimal harm or potential for actual harm
03/11/2010	proper backup exit lighting.	Isolated	Minimal harm or potential for actual harm
03/11/2010	emergency lighting that can last at least 1 1/2 hours.	Widespread	Minimal harm or potential for actual harm
03/11/2010	did not have a written emergency evacuation plan.	Widespread	Minimal harm or potential for actual harm
03/11/2010	an approved installation, maintenance and testing program for fire alarm systems.	Widespread	Minimal harm or potential for actual harm
03/11/2010	properly maintained smoke detectors.	Widespread	Minimal harm or potential for actual harm
03/11/2010	an approved automatic sprinkler system connected to the fire alarm system.	Isolated	Minimal harm or potential for actual harm
03/11/2010	automatic sprinkler systems that have been maintained in working order.	Pattern	Minimal harm or potential for actual harm
03/11/2010	posted "No-smoking" signs in areas where smoking is not permitted or did not provide ashtrays where smoking was allowed.	Isolated	Minimal harm or potential for actual harm
03/11/2010	properly protected cooking facilities.	Isolated	Minimal harm or potential for actual harm
03/11/2010	restrictions on the use of portable space heaters.	Pattern	Minimal harm or potential for actual harm
03/11/2010	fire safety features required by current fire safety codes.	Pattern	Minimal harm or potential for actual harm
03/11/2010	no-smoking signs where oxygen is used.	Isolated	Minimal harm or potential for actual harm
03/11/2010	weekly inspections and monthly testing of generators.	Pattern	Minimal harm or potential for actual harm
03/11/2010	properly installed electrical wiring and equipment.	Pattern	Minimal harm or potential for actual harm
03/11/2010	back-up procedures in place for a faulty automatic sprinkler system.	Widespread	Minimal harm or potential for actual harm
03/11/2010	an approved back-up procedure for a faulty fire alarm system.	Widespread	Minimal harm or potential for actual harm
04/06/2009	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.	Pattern	Minimal harm or potential for actual harm
04/06/2009	Write and use a policy that lets each resident return to the nursing home after a hospital stay or leave for therapy.	Isolated	Minimal harm or potential for actual harm
04/06/2009	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
04/06/2009	Provide services to meet the needs and preferences of each resident.	Pattern	Potential for minimal harm
04/06/2009	Provide activities to meet the needs of each resident.	Pattern	Minimal harm or potential for actual harm
04/06/2009	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
04/06/2009	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
04/06/2009	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Actual harm
04/06/2009	Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.	Isolated	Minimal harm or potential for actual harm
04/06/2009	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
04/06/2009	Prevent a loss in range of motion among residents who entered the nursing home with a full range of motion.	Isolated	Minimal harm or potential for actual harm
04/06/2009	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
04/06/2009	Develop/implement required procedures for the administration of immunizations.	Isolated	Minimal harm or potential for actual harm
04/06/2009	Have enough nurses to care for every resident in a way that maximizes the resident's well being.	Pattern	Minimal harm or potential for actual harm
04/06/2009	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
04/06/2009	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
04/06/2009	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
04/06/2009	Make sure that doctors visit residents regularly, as required.	Pattern	Minimal harm or potential for actual harm
04/06/2009	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
04/06/2009	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Minimal harm or potential for actual harm
04/06/2009	Follow all laws and professional standards.	Pattern	Minimal harm or potential for actual harm
04/06/2009	Get proof that a nurse aide has the training and skills that the State requires.	Isolated	Minimal harm or potential for actual harm
04/06/2009	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
02/20/2009	an approved automatic sprinkler system connected to the fire alarm system.	Isolated	Minimal harm or potential for actual harm
02/20/2009	corridors that are separated from common areas by walls constructed to limit the passage of smoke.	Isolated	Minimal harm or potential for actual harm
02/20/2009	corridor and hallway doors that block smoke.	Isolated	Minimal harm or potential for actual harm
02/20/2009	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
02/20/2009	construction that can resist fire for one hour or an approved fire extinguishing system.	Isolated	Minimal harm or potential for actual harm
02/20/2009	exits that are accessible at all times.	Isolated	Minimal harm or potential for actual harm
02/20/2009	a fire alarm system that can be heard throughout the facility.	Widespread	Minimal harm or potential for actual harm
02/20/2009	posted "No-smoking" signs in areas where smoking is not permitted or did not provide ashtrays where smoking was allowed.	Isolated	Minimal harm or potential for actual harm
02/20/2009	properly installed electrical wiring and equipment.	Isolated	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