NEVILLE CENTER AT FRESH POND FOR NURSING & REHAB

Nursing Home Inspector

640 CONCORD AVENUE
CAMBRIDGE, MA 02138
Middlesex County
Phone: 617-497-0600
Provider Number: 225378
Last Inspection: 06/27/2017

About the Nursing Home

Number of Beds: 112
Number of Residents: 103
Beds Available: 9
Percent Occupancy: 92%
Insurance Accepted: Medicare & Medicaid
Types of Councils: Both
Ownership: Non profit - Other
Within Hospital?: NO

About State Inspection Deficiencies

Nursing Homes that are Medicare and/or Medicaid certified are licensed by the state and are required to comply with rigid standards enforced by regular facility inspections and extensive evaluations.

The state inspection deficiencies provided here are accounts reported by state inspectors of every discrepancy found where the home failed to meet the minimum standards set forth by state and federal regulations. If a home does not show any deficiencies, it has met the minimum standards required.

Please note: Findings in these inspections do not present a complete picture of the quality of care provided. Information in this database should be interpreted carefully and used in conjunction with other sources, as well as a visit to the nursing home.


Deficiency Ratings

Our nursing home inspector tool compares the severity of deficiences rather than the number of deficiences. We calculate the severity of each deficiency using the formula:

Severity Rating = Scope + Level of Harm.

Deficiency Rating= Sum of ALL Severity Ratings

Severity Scope Level of Harm
2 1-Isolated 1-Potential for minimal harm
3 2-Pattern 1-Potential for minimal harm
3 1-Isolated 2-Minimal harm or potential for actual harm
4 3-Widespread 1-Potential for minimal harm
4 2-Pattern 2-Minimal harm or potential for actual harm
4 1-Isolated 3-Actual harm
5 3-Widespread 2-Minimal harm or potential for actual harm
5 2-Pattern 3-Actual harm
5 1-Isolated 4-Immediate jeopardy to resident health or safety
6 3-Widespread 3-Actual harm
6 2-Pattern 4-Immediate jeopardy to resident health or safety
7 3-Widespread 4-Immediate jeopardy to resident health or safety

Deficiency Ratings
By Region

Lower Numbers Are Better

 

0

Facility
15

County
16

MA
20

USA

Deficiency Ratings
By Year

Lower Numbers Are Better

 

0

2017
17

2016
0

2015

Medicare Ratings

Overall Rating: Overall Rating
Health Rating: Health Rating
Staff Rating: Staff Rating
Quality Rating: Quality Rating

 

Details by Inspection Date

7/21/2016 Inspection

 
Deficiency Description Scope : Level of Harm 1 -- Rating -- 7 Corrected
Failed To: Ensure services provided by the nursing facility meet professional standards of quality. Isolated : Minimal 3 8/5/2016
 
Failed To: Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. Isolated : Minimal 3 8/5/2016
 
Failed To: Keep all essential equipment working safely. Pattern : Minimal 4 8/5/2016
 
Failed To: Ensure laboratory services, blood blanks and transfusion services provided on site meet requirements for certified laboratories; or have an agreement to obtain services from an offsite laboratory, that meets the same requirements. Pattern : Minimal 4 8/5/2016
 
Failed To: Keep accurate, complete and organized clinical records on each resident that meet professional standards. Isolated : Minimal 3 8/5/2016
 

Complaint Investigation Deficiencies

These deficiencies resulted from complaints investigated by the state inspectors and substantiated.

No Complaint Deficiencies Reported

About The Staff

(Higher Numbers Are Better)

Staffing Hours Per Day Per Resident... This Facility County Avg MA State Avg
Number of Residents 103 94.05 96.79
Registered Nurses 1.40 0.87 0.89
Licensed Practical / Vocational Nurses 0.64 0.87 0.84
Certified Nursing Assistants 2.05 2.27 2.30
Total Staff Hours 4.08 4.01 4.03

 


About the Residents

(Lower Numbers Are Better)

Percent of Residents... This Facility% County Avg% MA State Avg%
of high risk long-stay residents with pressure ulcers 4 4 4
of long-stay residents assessed and appropriately given the pneumococcal vaccine 100 92 92
of long-stay residents assessed and appropriately given the seasonal influenza vaccine 100 95 95
of long-stay residents experiencing one or more falls with major injury 2 3 3
of long-stay residents who have depressive symptoms 0 2 2
of long-stay residents who lose too much weight 1 6 5
of long-stay residents who received an antianxiety or hypnotic medication 12 18 20
of long-stay residents who received an antipsychotic medication 14 18 18
of long-stay residents who self-report moderate to severe pain 0 4 4
of long-stay residents who were physically restrained 0 0 0
of long-stay residents whose ability to move independently worsened 12 16 18
of long-stay residents whose need for help with daily activities has increased 7 13 14
of long-stay residents with a catheter inserted and left in their bladder 0 1 1
of long-stay residents with a urinary tract infection 3 3 3
of low risk long-stay residents who lose control of their bowels or bladder 39 54 54
of short-stay residents assessed and appropriately given the pneumococcal vaccine 100 80 79
of short-stay residents who had an outpatient emergency department visit 14 11 11
of short-stay residents who made improvements in function 87 55 60
of short-stay residents who newly received an antipsychotic medication 1 1 1
of short-stay residents who self-report moderate to severe pain 3 11 14
of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine 98 82 82
of short-stay residents who were rehospitalized after a nursing home admission 22 22 22
of short-stay residents who were successfully discharged to the community 71 54 56
of short-stay residents with pressure ulcers that are new or worsened 0 0 0