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NATIONAL NURSING HOME WATCH LIST

GOLDEN EMPIRE CONV HOSP: Actual Harm and/or Immediate Jeopardy

121 DORSEY DRIVE

GRASS VALLEY CA

TELEPHONE: 5302731316

TYPE OF OWNERSHIP: For profit - Partnership

NUMBER OF BEDS / PERCENT OCCUPIED: 148 / 83

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Based on the annual and complaint survey data reported by CMS as of 02/27/08 , this home is listed because in at least one area they caused actual harm to a patient and/or subjected the patients to immediate jeopardy. More recent reports/corrections may be available. Check with the nursing home administrator. Actual harm is indicated by a score of G, H, I, while J, K, L indicate immediate jeopardy. The color coding scheme is below:
RATING DEFINITION
actual harm and/or immediate jeopardy: score= G,H,I,J,K,L
potential for more than minimal harm: score= D, E, F
potential for minimal harm: score= A, B, C
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RESULTS LISTED BASED ON MOST RECENT ANNUAL SURVEY DATED: 03/08/2007
RATING VIOLATION SCOPE/SEVERITY CODE
At least once a month, have a licensed pharmacist check the drugs that each resident takes. D
Give professional services that follow each resident's written care plan. D
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. D
Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them. D
Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses. E
Hire a qualified dietician. F
Make sure that residents are well nourished. E
Store, cook, and give out food in a safe and clean way. F
Make sure that doctors visit residents regularly, as required. D
Keep each resident's personal and medical records private and confidential. D
Have a program to keep infection from spreading. D
Keep accurate and appropriate medical records. B
Have a detailed, written plan for disasters and emergencies. C
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. G
Provide care in a way that keeps or builds each resident's dignity and self respect. D

COMPLAINT SURVEY RESULTS: SUBSTANTIATED

DATERATINGCOMPLAINT VIOLATION CONFIRMEDSCOPE/SEVERITY CODE
08/04/2005 Provide enough notice before discharging or transferring a resident. G
08/04/2005 Tell the resident or the resident's representative in writing how long the nursing home will hold the resident's bed when the resident temporarily leaves the facility. G
08/04/2005 Write and use a policy that lets each resident return to the nursing home after a hospital stay or leave for therapy. G
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