CA Nursing Homes:
Violations Key
Be sure to note the effective dates of this information on the county list page.
The information on violations comes to CANHR from the California Department
of Health Services (DHS), Licensing and Certification (LCD) Branch; some of
it comes from the central state office, some from regional district offices.
CANHR organizes the data into a form intended to be easily comprehensible to
consumers.
Please note: CANHR makes every effort to ensure that the
information posted is accurate and up to date. Because CANHR relies
directly on data from the Department of Health Services, CANHR
cannot directly guarantee the accuracy of all data. If you are
aware of an error in the information, please send a letter with
the correct information to CANHR, 650 Harrison Street, 2nd Floor,
San Francisco, CA 94107, or you may contact the CANHR office at
(415) 974-5171, and we will verify the source of the error. All
verified errors will be corrected as soon as possible.
A blank column indicates no violations or complaints (read as zeros).
The average capacity of California skilled nursing facilities is approximately
90. One might expect the number of complaints and citations to scale proportiionately
with the capacity of the facility, but that deficiencies would be less affected
by size since they are more related to the overall operation of each single
facility.
Citations: Citations are issued by the Department of Heath Services
(DHS) during the annual certification visit, complaint investigations or special
incident investigations for violations of state or federal law. Citations come
in several classes depending on their severity. The state average is a little
less than one per facility per year, but ideally, a facility should not have
any citations; many facilities have few or none. Some facilities have numerous
citations which indicates potential problems. The state issues the following
classes, as well as the less frequent citations for the falsification of medical
records (not listed).
-
Class AA: The most serious violation, AA citations are issued when a resident death has occurred in such a way that it has been directly and officially attributed to the responsibility of the facility, and carry fines of $25,000 to $100,000.
- Class A: Class A citations are issued when violations present imminent danger to patients or the substantial probability of death or serious harm, and carry fines from $2,000 to $20,000.
- Class B: Class B citations carry fines from $100 to $1000 and are issued for violations which have a direct or immediate relationship to health, safety, or security, but do not qualify as A or AA citations.
As of February 2002, the CANHR website will show the current status for the
class and fine of citations (as of CANHR's last quarterly receipt of data).
Formerly, the numbers shown were of citations as-issued by the
DHS, regardless of ultimate outcome.
On the lists of facilities that appear by county on this website, an asterisk
(*) after an entry means that one or more of the citations under that entry
was originally issued as some other class. Example: 3*.
For more information about the class as-issued, or outcome of citations (e.g.
results of an appeal in a Citation Review Conference), call CANHR
at 415/ 974-5171.
Complaints: Complaints are primarily consumer complaints filed with
the Department of Health Services, but this number does not include complaints
filed solely with the Ombudsman program. They may be filed by anyone, residents,
relatives, ombudsmen or passers-by. Complaints shown could be filed in writing
or by phone; in our view, complaints are not often filed frivolously. The totals
shown include the infrequent cases in which a facility must self-report an event
when required by law. Complaints can indicate the overall level of consumer
satisfaction or dissatisfaction. The state average is shown for each year for
comparison.
Deficiencies: Deficiencies are usually federal violations issued during
the (approximately annual) inspection by the Department of Health Services,
but may be issued at other times, as well. The state average number of deficiencies
per facility is listed for each year. If no deficiencies are listed in the most
recent year, it may mean that the facility has not had its annual survey yet.
We recommend that, as part of investigating a potential facility, you ask the
administrator of the facility to let you read through the facility's most recent
licensing inspection ("Survey") report; and that you ask about anything
that concerns you as you do; this document is supposed to be available to you
on the facility premises and you should be allowed plenty of time to go through
it to your satisfaction. Keep in mind that the facility may have received more
deficiencies than appear in the survey; call CANHR to see whether we have more
complete information.
Tips on interpreting this data
This information should not be used as the sole measure of quality of care
in a nursing home. While high numbers of violations generally indicate troubled
facilities, a facility with low numbers may not necessarily offer excellent
care. Many variables affect these statistics, making an absolute numerical comparison
less than perfect for choosing a facility. For example, different DHS branch
offices vary widely in their enforcement of the law.
It is important to visit potential facilities. Use the data listed here
to select facilities that seem promising in terms of location, services and
violation records, but then visit the facilities. CANHR has an evaluation checklist
(included with the Pre-Placement Packet which may be ordered from us) to assist
in the decision-making process.
If you have questions, call CANHR at (415) 974-5171 or
(800) 474-1116 (consumers only, please).
