TOTALLY KIDS SPECIALTY HEALTHCARE

The nursing staff is the most important part of what determines the quality of care and comfort of a resident in a nursing home. Government regulations set expectations on time spent with each resident based on the services being provided. The breakdown below lists the nursing types (RN, LPN, LVN, CNA) and a comparison of the reported and expected hours per resident per day.

Medicare determines quality of care ratings for nursing facilities by surveying several "quality measures", which are broken down into long-term and short-term stay residents, as well as if the action is preventive or if there is a deficiency in the quality of care. State averages for California are also provided for comparison purposes. Note: Figures below are averaged over the past nine months.

Long-Term Stay Preventive Actions

Long-Term Stay Deficiencies

All Medicare and/or Medicaid certified nursing home must undergo health inspections on average once a year, but may be more frequent if the facility is peforming poorly. These inspections cover most aspects of life in a nursing home, and are broken down into deficiencies types, which including: Pharmacy Service, Administration, Resident Rights, Nutrition and Dietary, Resident Assessment, Environmental, and Mistreatment. Below are the list of deficiencies found by inspectors in the past few years along with the degree of harm and how many residents may have been affected. Note: The most recent health survey was on 08/09/2010.

Administration

Train All Employees on What to Do in an Emergency. Inspection Date: 05/30/2008 Correction Date: 07/15/2008

Environmental

Provide Needed Housekeeping and Maintenance. Inspection Date: 05/30/2008 Correction Date: 07/15/2008
Have a Program to Keep Infection from Spreading. Inspection Date: 05/30/2008 Correction Date: 07/15/2008
Have a Program to Keep Infection from Spreading. Inspection Date: 08/09/2010 Correction Date: 10/14/2010

Mistreatment

Write and Use Policies That Forbid Mistreatment, Neglect and Abuse of Residents and Theft of Residents' Property. Inspection Date: 05/30/2008 Correction Date: 07/15/2008
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. Inspection Date: 08/09/2010 Correction Date: 10/14/2010

Nutrition and Dietary

Prepare Food That is Nutritional, Appetizing, Tasty, Attractive, Well-Cooked, and at the Right Temperature. Inspection Date: 07/17/2009 Correction Date: 08/31/2009
Store, Cook, and Give out Food in a Safe and Clean Way. Inspection Date: 07/17/2009 Correction Date: 08/31/2009
Store, Cook, and Give out Food in a Safe and Clean Way. Inspection Date: 08/09/2010 Correction Date: 10/14/2010

Pharmacy Service

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. Inspection Date: 05/30/2008 Correction Date: 07/15/2008
Properly Mark Drugs and Other Similar Products. Inspection Date: 05/30/2008 Correction Date: 07/15/2008
Make Sure That Residents Are Safe from Serious Medication Errors. Inspection Date: 07/17/2009 Correction Date: 08/31/2009

Quality Care

Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible. Inspection Date: 05/30/2008 Correction Date: 07/15/2008
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Inspection Date: 05/30/2008 Correction Date: 07/15/2008
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. Inspection Date: 05/30/2008 Correction Date: 07/15/2008
Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible. Inspection Date: 07/17/2009 Correction Date: 08/31/2009
Give Residents Proper Treatment to Prevent New Bed (Pressure) Sores or Heal Existing Bed Sores. Inspection Date: 07/17/2009 Correction Date: 08/31/2009
Make Sure That Residents with Reduced Range of Motion Get Proper Treatment and Services to Increase Range of Motion. Inspection Date: 07/17/2009 Correction Date: 08/31/2009
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. Inspection Date: 07/17/2009 Correction Date: 08/31/2009
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Inspection Date: 08/09/2010 Correction Date: 10/14/2010
Make Sure That Residents with Reduced Range of Motion Get Proper Treatment and Services to Increase Range of Motion. Inspection Date: 08/09/2010 Correction Date: 10/14/2010
Give Each Resident Enough Fluids to Keep Them Healthy and Prevent Dehydration. Inspection Date: 08/09/2010 Correction Date: 10/14/2010
Develop/Implement Required Procedures for the Administration of Immunizations. Inspection Date: 08/09/2010 Correction Date: 10/14/2010

Resident Assessment

Make Sure All Assessments Are Accurate, Coordinated by an Rn, Done by the Right Professional, and Are Signed by the Person Completing Them. Inspection Date: 05/30/2008 Correction Date: 07/15/2008
Develop a Complete Care Plan That Meets All of a Resident's Needs, with Timetables and Actions That Can Be Measured. Inspection Date: 07/17/2009 Correction Date: 08/31/2009
Develop a Complete Care Plan That Meets All of a Resident's Needs, with Timetables and Actions That Can Be Measured. Inspection Date: 08/09/2010 Correction Date: 10/14/2010

Resident Rights

Tell the Resident Completely About His or Her Health Status. Inspection Date: 05/30/2008 Correction Date: 07/15/2008
Keep Each Resident's Personal and Medical Records Private and Confidential. Inspection Date: 05/30/2008 Correction Date: 07/15/2008
Have a Private Telephone Available for Use. Inspection Date: 05/30/2008 Correction Date: 07/15/2008
Provide Care in a Way That Keeps or Builds Each Resident's Dignity and Self Respect. Inspection Date: 05/30/2008 Correction Date: 07/15/2008
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. Inspection Date: 07/17/2009 Correction Date: 08/31/2009
Try to Resolve Each Resident's Complaints Quickly. Inspection Date: 08/09/2010 Correction Date: 10/14/2010

Nursing homes certified by Medicare and/or Medicaid are required to have fire safety inspections to meet Life Safety Code (LSC) standards. Below is a list of deficiencies that Totally Kids Specialty Healthcare had in recent fire safety inspections. This information can be used to see if all standards were met, the degree of harm, the number of residents affected, and the date when deficiencies were corrected. Note: The most recent fire safety survey was on 08/12/2010.

Automatic Sprinkler Systems

Automatic Sprinkler Systems That Have Been Maintained in Working Order. Inspection Date: 06/12/2008 Correction Date: 07/08/2008
Portable Fire Extinguishers. Inspection Date: 06/12/2008 Correction Date: 07/08/2008
Back-Up Procedures in Place for a Faulty Automatic Sprinkler System. Inspection Date: 06/12/2008 Correction Date: 07/08/2008
Portable Fire Extinguishers. Inspection Date: 07/08/2009 Correction Date: 08/20/2009

Building Construction

Approved Construction Type or Materials. Inspection Date: 07/08/2009 Correction Date: 08/20/2009
Approved Construction Type or Materials. Inspection Date: 08/12/2010 Correction Date: 09/01/2010

Building Service Equipment

Heating and Ventilation Systems That Have Been Properly Installed According to the Manufacturer's Instructions. Inspection Date: 07/08/2009 Correction Date: 08/20/2009

Corridor Walls and Doors

Corridor and Hallway Doors That Block Smoke. Inspection Date: 06/12/2008 Correction Date: 07/08/2008

Electrical

Weekly Inspections and Monthly Testing of Generators. Inspection Date: 06/12/2008 Correction Date: 07/08/2008
Properly Installed Electrical Wiring and Equipment. Inspection Date: 06/12/2008 Correction Date: 07/08/2008
Properly Installed Electrical Wiring and Equipment. Inspection Date: 07/08/2009 Correction Date: 08/20/2009

Fire Alarm Systems

A Fire Alarm System That Can Be Heard Throughout the Facility. Inspection Date: 08/12/2010 Correction Date: 09/01/2010

Smoke Compartmentation and Control

Walls or Barriers That Prevent Smoke from Passing Through and Would Resist Fire for at Least One Hour. Inspection Date: 07/08/2009 Correction Date: 08/20/2009
Smoke Barrier Doors That Can Resist Smoke for at Least 20 Minutes. Inspection Date: 08/12/2010 Correction Date: 09/01/2010