THE CLAYBERG

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 Illinois 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 03/11/2011.

Environmental

Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Inspection Date: 03/26/2009 Correction Date: 03/31/2009
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Inspection Date: 04/15/2010 Correction Date: 05/14/2010
Have a Program to Keep Infection from Spreading. Inspection Date: 03/11/2011 Correction Date: 04/25/2011
Make Sure That the Nursing Home Area is Safe, Easy to Use, Clean and Comfortable. Inspection Date: 03/11/2011 Correction Date: 04/25/2011
Have Enough Backup Water Supply for Important Areas of the Nursing Home. Inspection Date: 03/11/2011 Correction Date: 04/25/2011

Mistreatment

Write and Use Policies That Forbid Mistreatment, Neglect and Abuse of Residents and Theft of Residents' Property. Inspection Date: 03/11/2011 Correction Date: 04/25/2011

Nutrition and Dietary

Store, Cook, and Give out Food in a Safe and Clean Way. Inspection Date: 04/15/2010 Correction Date: 05/14/2010

Quality Care

Give Professional Services That Follow Each Resident's Written Care Plan. Inspection Date: 03/26/2009 Correction Date: 03/31/2009
Give Professional Services That Follow Each Resident's Written Care Plan. Inspection Date: 03/11/2011 Correction Date: 04/25/2011

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: 03/26/2009 Correction Date: 03/26/2009
1) Develop a Complete Care Plan Within 7 Days of Each Resident's Admission; 2) Prepare a Care Plan with the Care Team, Including the Primary Nurse, Doctor, Resident or Resident's Family or Representative; or 3) Check and Update the Care Plan. Inspection Date: 03/11/2011 Correction Date: 04/25/2011

Resident Rights

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. Inspection Date: 03/26/2009 Correction Date: 03/31/2009
Allow Residents to Easily See the Results of the Nursing Home's Most Recent Survey. Inspection Date: 03/11/2011 Correction Date: 04/25/2011

The table below lists incident reports by the nursing staff or administration for The Clayberg, as well as complaints by residents or their family in the previous three years.

Administration

1) Set Up a Group That is Legally Responsible for Writing and Setting Up Policies for Leading and Running the Nursing Home; or 2) Hire a Properly Licensed Administrator. Complaint Filed: 03/26/2009 Correction Date: 03/31/2009
Get Proof That a Nurse Aide Has the Training and Skills That the State Requires. Complaint Filed: 01/28/2010 Correction Date: 03/05/2010

Quality Care

Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible. Complaint Filed: 01/28/2010 Correction Date: 03/05/2010

Resident Rights

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. Complaint Filed: 01/28/2010 Correction Date: 03/05/2010

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 The Clayberg 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 03/16/2011.

Automatic Sprinkler Systems

Back-Up Procedures in Place for a Faulty Automatic Sprinkler System. Inspection Date: 03/16/2011 Correction Date: 04/25/2011

Building Service Equipment

Heating and Ventilation Systems That Have Been Properly Installed According to the Manufacturer's Instructions. Inspection Date: 05/04/2009 Correction Date: 06/18/2009
Properly Protected Cooking Facilities. Inspection Date: 05/04/2009 Correction Date: 06/18/2009
Properly Protected Cooking Facilities. Inspection Date: 03/16/2011 Correction Date: 04/25/2011

Corridor Walls and Doors

Signs That State That Exit Doors Are to Be Kept Closed. Inspection Date: 05/04/2009 Correction Date: 06/18/2009
Corridor and Hallway Doors That Block Smoke. Inspection Date: 03/16/2011 Correction Date: 04/25/2011

Electrical

Weekly Inspections and Monthly Testing of Generators. Inspection Date: 03/16/2011 Correction Date: 04/25/2011
Properly Installed Electrical Wiring and Equipment. Inspection Date: 03/16/2011 Correction Date: 04/25/2011

Emergency Plans and Fire Drills

Record of Quarterly Fire Drills for Each Shift Under Varying Conditions. Inspection Date: 05/04/2009 Correction Date: 06/18/2009
Record of Quarterly Fire Drills for Each Shift Under Varying Conditions. Inspection Date: 03/16/2011 Correction Date: 04/25/2011

Fire Alarm Systems

An Approved Back-Up Procedure for a Faulty Fire Alarm System. Inspection Date: 03/16/2011 Correction Date: 04/25/2011

Illumination and Emergency Power

Emergency Lighting That Can Last at Least 1 1/2 Hours. Inspection Date: 05/04/2009 Correction Date: 06/18/2009

Smoke Compartmentation and Control

Walls or Barriers That Prevent Smoke from Passing Through and Would Resist Fire for at Least One Hour. Inspection Date: 03/16/2011 Correction Date: 04/25/2011