General Information: HARBOR VILLA CARE CENTER
Nursing home name HARBOR VILLA CARE CENTER
Address861 S. HARBOR BLVD
ANAHEIM, CA 92805
Phone number (714) 635-8131
Located within a hospital No
Type of ownership For profit - Corporation
Owner operates multiple homesYes
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityNo
Resident and family councils Both
Certified number of beds 99
Total number of residents 83
Perc of occupied beds 83
Sprinkler status Yes
Number of Facility Reported Incidents0
Number of Substantiated Complaints3
Number of Fines1
Total Amount of Fines$11000
Total Number of Penalties0
Total Number of Penalties1
Ratings Summary: HARBOR VILLA CARE CENTER
Overall rating 2
2
Nursing Home Staffing 3
3
Registered Nurses only 2
2
Health Inspections 1
1
Quality Measures 5
5
Nursing Home Staffing Info: HARBOR VILLA CARE CENTER
National AverageCalifornia AverageHARBOR VILLA CARE CENTER
Overall staff rating NA NA 3
3
Registered Nurses only rating NANA 2
2
Total Number of Residents NA NA 83
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 4.49 hours 3.87 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.8 hours 1.38 hours
Registered Nurses Hours per Residents per Day 0.81 hours 0.88 hours 0.43 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.92 hours 0.96 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.69 hours 2.48 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.14 hours 0.15 hours
Health Survey: HARBOR VILLA CARE CENTER
Heath Survey Summary on 2013-08-29
Total Number of Health Deficiencies 12
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Heath Survey Summary on 2012-09-19
Total Number of Health Deficiencies 13
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Heath Survey Summary on 2011-05-31
Total Number of Health Deficiencies 8
Scope and Severity of most Severe Health Deficiency Widespread /Immediate jeopardy to resident health or safety
Health Survey Details: HARBOR VILLA CARE CENTER
Inspection Results: 08/29/2013
Corrected Deficiency Scope and Severity
09/27/2013 Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. Pattern/Potential for minimal harm
09/27/2013 Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Pattern/Minimal harm or potential for actual harm
09/27/2013 Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated/Minimal harm or potential for actual harm
09/27/2013 Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions. Isolated/Minimal harm or potential for actual harm
09/27/2013 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Isolated/Minimal harm or potential for actual harm
09/27/2013 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Minimal harm or potential for actual harm
09/27/2013 Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. Pattern/Potential for minimal harm
09/27/2013 Make sure that special or therapeutic diets are ordered by the attending doctor. Isolated/Minimal harm or potential for actual harm
09/27/2013 Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. Isolated/Minimal harm or potential for actual harm
09/27/2013 Have a program that investigates, controls and keeps infection from spreading. Isolated/Minimal harm or potential for actual harm
09/27/2013 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Isolated/Minimal harm or potential for actual harm
09/27/2013 Set up an ongoing quality assessment and assurance group to review quality deficiencies quarterly, and develop corrective plans of action. Isolated/Minimal harm or potential for actual harm
Inspection Results: 09/19/2012
Corrected Deficiency Scope and Severity
10/08/2012 Develop a post-discharge plan with the resident and family for the resident's care after leaving the nursing home. Isolated/Minimal harm or potential for actual harm
10/08/2012 Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions. Isolated/Minimal harm or potential for actual harm
10/08/2012 Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated/Minimal harm or potential for actual harm
10/08/2012 Coordinate assessments with the pre-admission screening and resident review program for mentally-ill and mentally-retarded patients. Pattern/Potential for minimal harm
10/08/2012 Ensure residents maintain acceptable nutritional status. Isolated/Minimal harm or potential for actual harm
10/08/2012 Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. Isolated/Minimal harm or potential for actual harm
10/08/2012 Keep each resident free from physical restraints, unless needed for medical treatment. Isolated/Minimal harm or potential for actual harm
10/08/2012 Try to resolve each resident's complaints quickly. Isolated/Minimal harm or potential for actual harm
10/08/2012 Ensure that residents are fully informed and understand their health status, care and treatments. Isolated/Minimal harm or potential for actual harm
10/08/2012 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Minimal harm or potential for actual harm
10/08/2012 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Isolated/Minimal harm or potential for actual harm
10/08/2012 Have a program that investigates, controls and keeps infection from spreading. Isolated/Minimal harm or potential for actual harm
10/08/2012 At least once a month, have a licensed pharmacist review each resident's medication(s) and report any irregularities to the attending doctor. Isolated/Minimal harm or potential for actual harm
Inspection Results: 05/31/2011
Corrected Deficiency Scope and Severity
07/20/2011 Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible. Pattern/Potential for minimal harm
08/19/2011 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Widespread /Immediate jeopardy to resident health or safety
07/20/2011 Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses. Isolated/Minimal harm or potential for actual harm
07/20/2011 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Minimal harm or potential for actual harm
07/20/2011 Make sure that a working call system is available in each resident's room or bathroom and bathing area. Pattern/Potential for minimal harm
07/20/2011 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Pattern/Potential for minimal harm
07/20/2011 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Isolated/Minimal harm or potential for actual harm
07/20/2011 Train all employees on what to do in an emergency, and carry out unannounced staff drills. Isolated/Minimal harm or potential for actual harm

Fire Safety Survey: HARBOR VILLA CARE CENTER
Fire Safety Survey Summary on 2013-09-05
Total Number of Fire SafetyDeficiencies 5
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2012-09-18
Total Number of Fire SafetyDeficiencies 2
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2011-06-01
Total Number of Fire SafetyDeficiencies 3
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey: HARBOR VILLA CARE CENTER
Fire Safety Survey Results: 09/05/2013
Corrected Deficiency Severity
09/24/2013 An approved installation, maintenance and testing program for fire alarm systems. Isolated/Minimal harm or potential for actual harm
09/24/2013 Portable fire extinguishers. Isolated/Minimal harm or potential for actual harm
09/24/2013 Proper medical gas storage and administration areas. Isolated/Minimal harm or potential for actual harm
09/24/2013 Properly installed electrical wiring and equipment. Pattern/Minimal harm or potential for actual harm
09/24/2013 Properly installed hallway dispensers for alcohol-based hand rub. Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Results: 09/18/2012
Corrected Deficiency Severity
09/27/2012 An approved installation, maintenance and testing program for fire alarm systems. Isolated/Minimal harm or potential for actual harm
09/27/2012 A complete sprinkler system with alarm system connection. Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Results: 06/01/2011
Corrected Deficiency Severity
06/13/2011 Approved construction type or materials. Isolated/Minimal harm or potential for actual harm
06/13/2011 Walls that prevent smoke from passing through and would resist fire for at least one hour. Pattern/Minimal harm or potential for actual harm
06/13/2011 A fire alarm system that can be heard throughout the facility. Isolated/Minimal harm or potential for actual harm

Resident Complaints: HARBOR VILLA CARE CENTER
Date Complaint Substantiated: 03/25/2013
CorrectedCategoryDeficiencySeverity
03/29/2013Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. D
Date Complaint Substantiated: 06/21/2012
CorrectedCategoryDeficiencySeverity
07/12/2012Provide care for residents in a way that maintains or improves their dignity and respect in full recognition of their individuality. D
Date Complaint Substantiated: 06/20/2012
CorrectedCategoryDeficiencySeverity
07/31/2012Provide necessary care and services to maintain or improve the highest well being of each resident . G
07/31/2012Keep accurate, complete and organized clinical records on each resident that meet professional standards. D

Quality Measures: HARBOR VILLA CARE CENTER
Quality Measures National Average California Average HARBOR VILLA CARE CENTER
Overall quality rating NA NA 5
5
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 11.7% 7.8%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 5.9% 3.2%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 6.2% 1.3%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 5.8% 0.5%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 45.3% 59.5%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 3.3% 3.8%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 5.3% 3.2%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 1.8% 3.4%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 2.1% 1.3%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 1.6% 0.9%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 92.3% 94.6%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 94.6% 99.6%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 16.5% 35.3%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 16.9% 5.8%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 0.9% 0.0%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 81.1% 87.2%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 79.8% 87.6%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 2.0% 4.3%

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