General Information: DEANWOOD REHABILITATION AND WELLNESS CENTER
Nursing home name DEANWOOD REHABILITATION AND WELLNESS CENTER
Address5000 BURROUGHS AVE. NE
WASHINGTON, DC 20019
Phone number (202) 399-7504
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 296
Total number of residents 249
Perc of occupied beds 84
Sprinkler status Partial
Number of Facility Reported Incidents6
Number of Substantiated Complaints5
Number of Fines1
Total Amount of Fines$38150
Total Number of Penalties1
Total Number of Penalties2
Ratings Summary: DEANWOOD REHABILITATION AND WELLNESS CENTER
Overall rating 2
2
Nursing Home Staffing 2
2
Registered Nurses only 4
4
Health Inspections 1
1
Quality Measures 5
5
Nursing Home Staffing Info: DEANWOOD REHABILITATION AND WELLNESS CENTER
National AverageDistrict of Columbia AverageDEANWOOD REHABILITATION AND WELLNESS CENTER
Overall staff rating NA NA 2
2
Registered Nurses only rating NANA 4
4
Total Number of Residents NA NA 249
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 4.98 hours 1.81 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 2.22 hours 1.81 hours
Registered Nurses Hours per Residents per Day 0.81 hours 1.13 hours 1.0 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 1.09 hours 0.81 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.76 hours 0.0 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.17 hours 0.15 hours
Health Survey: DEANWOOD REHABILITATION AND WELLNESS CENTER
Heath Survey Summary on 2013-03-26
Total Number of Health Deficiencies 27
Scope and Severity of most Severe Health Deficiency Isolated/Actual harm
Heath Survey Summary on 2012-03-28
Total Number of Health Deficiencies 32
Scope and Severity of most Severe Health Deficiency Isolated/Actual harm
Heath Survey Summary on 2011-04-21
Total Number of Health Deficiencies 22
Scope and Severity of most Severe Health Deficiency Isolated /Immediate jeopardy to resident health or safety
Health Survey Details: DEANWOOD REHABILITATION AND WELLNESS CENTER
Inspection Results: 03/26/2013
Corrected Deficiency Scope and Severity
05/22/2013 Give residents a notice of rights, rules, services and charges. Isolated/Minimal harm or potential for actual harm
06/20/2013 Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Isolated/Minimal harm or potential for actual harm
05/22/2013 Give notice to the resident before a room or roommate change. Isolated/Minimal harm or potential for actual harm
06/20/2013 Provide housekeeping and maintenance services. Pattern/Minimal harm or potential for actual harm
05/22/2013 Conduct initial and periodic assessments of each resident's functional capacity. Isolated/Minimal harm or potential for actual harm
05/22/2013 Ensure each resident receives an accurate assessment by a qualified health professional. Isolated/Minimal harm or potential for actual harm
06/20/2013 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
06/20/2013 Allow residents the right to participate in the planning or revision of care and treatment. Pattern/Minimal harm or potential for actual harm
06/20/2013 Ensure services provided by the nursing facility meet professional standards of quality. Isolated/Minimal harm or potential for actual harm
05/22/2013 Provide care by qualified persons according to each resident's written plan of care. Isolated/Minimal harm or potential for actual harm
06/20/2013 Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated/Actual harm
05/22/2013 Assist those residents who need help with eating/drinking, grooming and personal and oral hygiene. Pattern/Minimal harm or potential for actual harm
05/22/2013 Ensure that residents with limited range of motion receive appropriate treatment and services to increase range of motion or prevent further decrease in range of motion. Isolated/Minimal harm or potential for actual harm
06/20/2013 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Pattern/Minimal harm or potential for actual harm
05/22/2013 Ensure residents maintain acceptable nutritional status. Pattern/Minimal harm or potential for actual harm
05/22/2013 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
05/22/2013 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
05/22/2013 Store, cook, and serve food in a safe and clean way. Pattern/Minimal harm or potential for actual harm
05/22/2013 Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing. Isolated/Minimal harm or potential for actual harm
06/20/2013 Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse. Isolated/Minimal harm or potential for actual harm
06/20/2013 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
06/20/2013 Have a program that investigates, controls and keeps infection from spreading. Pattern/Minimal harm or potential for actual harm
06/20/2013 Keep all essential equipment working safely. Pattern/Minimal harm or potential for actual harm
06/20/2013 Operate and provide services according to Federal, State, and local laws and professional standards. Isolated/Minimal harm or potential for actual harm
06/20/2013 Give or get x-rays and other tests in a timely manner to meet the needs of residents. Isolated/Minimal harm or potential for actual harm
05/22/2013 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Isolated/Minimal harm or potential for actual harm
06/20/2013 Set up an ongoing quality assessment and assurance group to review quality deficiencies quarterly, and develop corrective plans of action. Pattern/Minimal harm or potential for actual harm
Inspection Results: 03/28/2012
Corrected Deficiency Scope and Severity
06/19/2012 Give residents a notice of rights, rules, services and charges. Isolated/Minimal harm or potential for actual harm
06/19/2012 Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Isolated/Minimal harm or potential for actual harm
06/19/2012 Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. Widespread /Minimal harm or potential for actual harm
06/19/2012 Provide residents with private access to a telephone. Isolated/Minimal harm or potential for actual harm
06/19/2012 Permit residents to remain in the facility and not be transferred or discharged without adequate reason. Isolated/Minimal harm or potential for actual harm
06/19/2012 1) Hire only people with 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. Isolated/Minimal harm or potential for actual harm
06/19/2012 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
06/19/2012 Provide care for residents in a way that maintains or improves their dignity and respect in full recognition of their individuality. Isolated/Minimal harm or potential for actual harm
07/06/2012 Give notice to the resident before a room or roommate change. Isolated/Minimal harm or potential for actual harm
07/06/2012 Provide housekeeping and maintenance services. Pattern/Minimal harm or potential for actual harm
06/19/2012 Maintain comfortable and safe temperature levels. Isolated/Minimal harm or potential for actual harm
06/19/2012 Conduct initial and periodic assessments of each resident's functional capacity. Isolated/Minimal harm or potential for actual harm
06/19/2012 Ensure each resident receives an accurate assessment by a qualified health professional. Pattern/Minimal harm or potential for actual harm
06/19/2012 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
06/19/2012 Allow residents the right to participate in the planning or revision of care and treatment. Pattern/Minimal harm or potential for actual harm
07/06/2012 Ensure services provided by the nursing facility meet professional standards of quality. Isolated/Minimal harm or potential for actual harm
07/06/2012 Provide necessary care and services to maintain or improve the highest well being of each resident . Pattern/Minimal harm or potential for actual harm
06/19/2012 Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. Isolated/Actual harm
07/06/2012 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. Isolated/Minimal harm or potential for actual harm
07/06/2012 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Pattern/Minimal harm or potential for actual harm
06/19/2012 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
06/19/2012 Store, cook, and serve food in a safe and clean way. Isolated/Minimal harm or potential for actual harm
06/19/2012 Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing. Isolated/Minimal harm or potential for actual harm
06/19/2012 Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse. Isolated/Minimal harm or potential for actual harm
06/19/2012 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
07/06/2012 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
07/06/2012 Have a program that investigates, controls and keeps infection from spreading. Widespread /Minimal harm or potential for actual harm
07/06/2012 Keep all essential equipment working safely. Widespread /Minimal harm or potential for actual harm
07/06/2012 Make sure that a working call system is available in each resident's room or bathroom and bathing area. Pattern/Minimal harm or potential for actual harm
06/19/2012 Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Pattern/Minimal harm or potential for actual harm
06/19/2012 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Pattern/Minimal harm or potential for actual harm
06/19/2012 Set up an ongoing quality assessment and assurance group to review quality deficiencies quarterly, and develop corrective plans of action. Widespread /Minimal harm or potential for actual harm
Inspection Results: 04/21/2011
Corrected Deficiency Scope and Severity
07/07/2011 Give residents a notice of rights, rules, services and charges. Pattern/Minimal harm or potential for actual harm
07/07/2011 Upon the death of a resident, convey the residents personal funds and an accounting of those funds to the appropriate party. Isolated/Minimal harm or potential for actual harm
07/07/2011 Provide activities to meet the interests and needs of each resident. Isolated/Minimal harm or potential for actual harm
07/07/2011 Provide medically-related social services to help each resident achieve the highest possible quality of life. Isolated/Minimal harm or potential for actual harm
07/27/2011 Provide housekeeping and maintenance services. Pattern/Minimal harm or potential for actual harm
07/07/2011 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
07/07/2011 Allow residents the right to participate in the planning or revision of care and treatment. Isolated/Minimal harm or potential for actual harm
07/07/2011 Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated/Minimal harm or potential for actual harm
07/07/2011 Make sure that residents receive treatments/services to maintain or improve their ability to care for themselves. Isolated/Minimal harm or potential for actual harm
07/07/2011 Assist those residents who need help with eating/drinking, grooming and personal and oral hygiene. Isolated/Minimal harm or potential for actual harm
07/07/2011 Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. Isolated/Minimal harm or potential for actual harm
07/07/2011 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
07/27/2011 Store, cook, and serve food in a safe and clean way. Pattern/Minimal harm or potential for actual harm
07/27/2011 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
07/07/2011 Have a program that investigates, controls and keeps infection from spreading. Isolated /Immediate jeopardy to resident health or safety
07/07/2011 Keep all essential equipment working safely. Pattern/Minimal harm or potential for actual harm
07/07/2011 Make sure that a working call system is available in each resident's room or bathroom and bathing area. Isolated/Minimal harm or potential for actual harm
07/07/2011 Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Isolated/Minimal harm or potential for actual harm
07/07/2011 Make sure that the facility is administered in an acceptable way that maintains the well-being of each resident . Isolated/Minimal harm or potential for actual harm
07/07/2011 Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility Isolated/Minimal harm or potential for actual harm
07/07/2011 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Isolated/Minimal harm or potential for actual harm
07/07/2011 Set up an ongoing quality assessment and assurance group to review quality deficiencies quarterly, and develop corrective plans of action. Widespread /Minimal harm or potential for actual harm

Fire Safety Survey: DEANWOOD REHABILITATION AND WELLNESS CENTER
Fire Safety Survey Summary on 2013-03-27
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 Summary on 2012-03-29
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 2011-05-05
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: DEANWOOD REHABILITATION AND WELLNESS CENTER
Fire Safety Survey Results: 03/27/2013
Corrected Deficiency Severity
05/09/2013 Corridor and hallway doors that block smoke. Isolated/Minimal harm or potential for actual harm
05/09/2013 Walls that prevent smoke from passing through and would resist fire for at least one hour. Isolated/Minimal harm or potential for actual harm
05/09/2013 Other fire safety features required by fire safety codes. Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Results: 03/29/2012
Corrected Deficiency Severity
07/06/2012 An approved installation, maintenance and testing program for fire alarm systems. Pattern/Minimal harm or potential for actual harm
07/06/2012 Corridor and hallway doors that block smoke. Pattern/Minimal harm or potential for actual harm
07/06/2012 Other fire safety features required by fire safety codes. Pattern/Minimal harm or potential for actual harm
07/06/2012 Corridors that are separated from use areas by walls constructed to limit the passage of smoke. Pattern/Minimal harm or potential for actual harm
07/06/2012 Record of quarterly fire drills for each shift under varying conditions. Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Results: 05/05/2011
Corrected Deficiency Severity
07/05/2011 Corridors that are separated from use areas by walls constructed to limit the passage of smoke. Pattern/Minimal harm or potential for actual harm
07/05/2011 Corridor and hallway doors that block smoke. Pattern/Minimal harm or potential for actual harm
07/05/2011 Properly located and lighted "Exit" signs. Isolated/Minimal harm or potential for actual harm
07/05/2011 A properly located automatic smoke detector system in all hallways (new only). Isolated/Minimal harm or potential for actual harm
07/05/2011 Other fire safety features required by fire safety codes. Pattern/Minimal harm or potential for actual harm

Resident Complaints: DEANWOOD REHABILITATION AND WELLNESS CENTER
Date Complaint Substantiated: 02/21/2014
CorrectedCategoryDeficiencySeverity
04/02/2014Operate and provide services according to Federal, State, and local laws and professional standards. D
04/02/2014Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility D
04/02/2014Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. G
04/02/2014Have enough nurses to care for every resident in a way that maximizes the resident's well being. G
04/02/2014Make sure that the facility is administered in an acceptable way that maintains the well-being of each resident . D
04/02/2014Keep all essential equipment working safely. K
04/02/2014Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing. D
Date Complaint Substantiated: 02/10/2014
CorrectedCategoryDeficiencySeverity
03/11/2014Allow residents the right to participate in the planning or revision of care and treatment. D
03/11/2014Keep accurate, complete and organized clinical records on each resident that meet professional standards. D
Date Complaint Substantiated: 01/17/2014
CorrectedCategoryDeficiencySeverity
03/07/2014Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. D
03/07/2014Protect each resident from mistreatment, neglect and misappropriation of personal property. D
Date Complaint Substantiated: 01/15/2014
CorrectedCategoryDeficiencySeverity
03/07/2014At least once a month, have a licensed pharmacist review each resident's medication(s) and report any irregularities to the attending doctor. D
03/07/2014Ensure 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. D
03/07/2014Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse. E
Date Complaint Substantiated: 12/06/2013
CorrectedCategoryDeficiencySeverity
02/11/2014Set up an ongoing quality assessment and assurance group to review quality deficiencies quarterly, and develop corrective plans of action. D
02/11/2014Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. D
02/11/2014Keep all essential equipment working safely. F
02/11/2014Store, cook, and serve food in a safe and clean way. F
Date Complaint Substantiated: 02/12/2013
CorrectedCategoryDeficiencySeverity
03/12/2013Operate and provide services according to Federal, State, and local laws and professional standards. D
03/12/2013Provide medically-related social services to help each resident achieve the highest possible quality of life. D
03/12/2013Keep accurate, complete and organized clinical records on each resident that meet professional standards. D
03/12/2013Develop a post-discharge plan with the resident and family for the resident's care after leaving the nursing home. D
03/12/2013Provide proper discharge planning and communication, of the resident's health status and summary of the resident's nursing home stay. D
Date Complaint Substantiated: 02/04/2013
CorrectedCategoryDeficiencySeverity
03/07/2013Operate and provide services according to Federal, State, and local laws and professional standards. E
Date Complaint Substantiated: 01/17/2012
CorrectedCategoryDeficiencySeverity
03/06/2012Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. G
Date Complaint Substantiated: 01/06/2012
CorrectedCategoryDeficiencySeverity
01/30/2012Provide necessary care and services to maintain or improve the highest well being of each resident . D
01/30/2012Keep accurate, complete and organized clinical records on each resident that meet professional standards. D
Date Complaint Substantiated: 11/08/2011
CorrectedCategoryDeficiencySeverity
12/12/2011Establish and follow a written policy that permits a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. D

Quality Measures: DEANWOOD REHABILITATION AND WELLNESS CENTER
Quality Measures National Average District of Columbia Average DEANWOOD REHABILITATION AND WELLNESS 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% 11.6% 27.4%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 2.3% 0.8%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 8.8% 6.3%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 6.4% 9.3%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 50.9% 51.1%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 1.6% 3.3%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 5.5% 2.2%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 3.6% 1.7%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 0.7% 0.0%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 1.4% 0.7%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 92.9% 84.1%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 91.8% 68.8%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 16.0% 20.2%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 9.6% 6.8%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 1.2% 1.3%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 76.8% 34.9%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 74.3% 21.2%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 2.7% 5.2%

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