Contract Nursing Home Exclusion Review

Part of the initial review for contracting and part of the annual review.

Name of Nursing Home HEARTLAND OF DUBLIN
Address 4075 WEST DUBLIN-GRANVILLE ROAD
DUBLIN OH, 43017
Telephone
Six Digit Provider Number 366418

A. Deficiencies

Rating (G-L) Program Requirements Corrected Date Current Survey Date
Deficiency Count: 0
Section Rating: PASS

*Facility fails if there are three level "G" or worse deficiencies in the current survey.

B. Health Requirement Deficiencies

Current Number at Facility State Average
Total Health Requirement Deficiencies: 2 6.1
Section Rating: PASS

Health Requirement Deficiencies: (The total number of health requirements deficiencies cannot be more than twice the State average in the current survey.)

C. Staff Treatment of Residents and Facility Licensure

Tag Title Program Requirements Rating Date of Survey Date of Correction Flagged
F221Physical RestraintsThe resident has the right to be free from any physical restraints imposed for purposes of discipline or convenience, and not required to treat the resident's medical symptoms.Violation not reported on current survey
F222Chemical RestraintsThe resident has the right to be free from any chemical restraints imposed for purposes of discipline or convenience, and not required to treat the resident's medical symptoms.To view full report Order Now
F223AbuseThe resident has the right to be free from averbal, sexual, physical and mental abuse, corporal punishment and involuntary seclusion.To view full report Order Now
F225Staff Treatment of ResidentsThe nursing home will not employ individuals who have been: found guilty of abusing, neglecting or mistreating residents by a court of law; have had a finding entered into the State nurse adie registry concerning abuse, neglect, mistreatment of residents or misappropriation of their property; and report any knowledge it has of actions by a court of law against an employee, which would indicate unfitness for service as a nurse aide or other facility staff to the State nurse aide registry or licensing authorities.To view full report Order Now
F226Staff Treatment of ResidentsThe facility must develop and implement written policies and procedures that prohibit mistreatment, neglect and abuse of residents and misappropriation of resident property.To view full report Order Now
F241DignityThe facility must promote care for residents in a manner and in an environment that maintains or enhances each resident's dignity and respect in full recognition of his or her individuality.To view full report Order Now
F491LicensureA facility must be licensed under applicable State and local law.To view full report Order Now
Section Rating: To view full report Order Now

* Fail with Rating E-L or higher: *OSCAR Level E-L equals Nursing Home Compare score of 2 or higher

D. RN Hours

RN Hours Current Average at Facility State Average
RN Hours per Resident Day: 1.20 0.85
Section Rating: PASS

* Program requirement: Fail if less than state average

E. Total Nursing Staff

Total Nursing Staff Current Average at Facility State Average
Total Nursing Staff Hours per resident Day: 4.7 4.07
Section Rating: PASS

* Program requirement: Fail if less than state average

F. Nursing Deficiencies

Tag Title Program Requirements Rating Date of Survey Date of Correction Flagged
F353NursingThe facility must provide services by suffiicient numbers of personnel on a 24-hour basis to provide nursing care to all residents in accordance with resident care plans.Violation not reported on current survey
F494Nursing Aide TrainingNursing Aides must have completed a training and competency evaluation program or a competency evaluation program approved by the State as meeting the requirements.To view full report Order Now
F495Nursing Aide CompetencyNursing Aides must have completed a training and competency evaluation program or a competency evaluation program approved by the State as meeting the requirements; has demonstrated competence through satisfactory participation in a State approved nursing aide training and competency evaluation program and has been deemed or determined competent.To view full report Order Now
F496Nursing Aide Registry VerificationThe facility must receive registry verification that the individual has met competency evaluation requirements with some exceptions.To view full report Order Now
F497Regular In-Service TrainingThe facility must complete a performance review of every nurse aide at least once every 12 months and must provide regular in-service education based on the outcome of these reviews.To view full report Order Now
F498Proficiency of Nursing AidesThe facility must ensure that nurse aides are able to demonstrate competency in skills and techniques necessary to care for resident assessments and described in the plan of care.To view full report Order Now
F499Staff QualificationsThe facility must employ on a full time, part-time or consultant basis those professionals necessary to carry out the provisions of these requirements. Professional staff must be licensed, certified or registered in accordance with applicable State laws.To view full report Order Now
Section Rating: To view full report Order Now

G. Quality Measures

NOTE:

Although the Centers for Medicare and Medicaid Services (CMS) has released 24 Quality Measures, current VHA guidelines indicate that the following 18 Quality Measures be used to determine Pass/Fail for Section G of the review.

Quality Measures Facility Percent State Average Flagged
Percentage of high risk long-stay residents with pressure ulcers 0% 4.5%
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine 0% 89.4%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine 0% 89.3%
Percentage of long-stay residents experiencing one or more falls with major injury 0% 3.3%
Percentage of long-stay residents who have depressive symptoms 0% 11.5%
Percentage of long-stay residents who lose too much weight 0% 6.7%
Percentage of long-stay residents who received an antipsychotic medication 0% 16.2%
Percentage of long-stay residents who self-report moderate to severe pain 0% 6%
Percentage of long-stay residents who were physically restrained 0% 0.4%
Percentage of long-stay residents whose need for help with daily activities has increased 0% 14%
Percentage of long-stay residents with a catheter inserted and left in their bladder 0% 1.7%
Percentage of long-stay residents with a urinary tract infection 0% 3.4%
Section Rating: To view full report Order Now

* A facility fails when six or more of the CMS Quality Measures listed below in Nursing Home Compare fall above the state average.
N.A.= contact home, data not submitted N.S. = contact home, numbers too small