HI-DESERT MEDICAL CENTER D/P SNF (JOSHUA TREE, CA) Detailed Nursing Home Profile

Process of Care

Heart Attack

Percent of Patients Given Aspirin at Arrival

Here:	89.0%
State:	99.3%

Percent of Patients Given Aspirin at Discharge

Here:	92.0%
State:	99.0%

Percent of Patients Given Beta Blocker at Discharge

Here:	79.0%
California:	98.5%

Average number of minutes before outpatients with chest pain or possible heart attack got an ECG

This Nursing Home:	13
California:	9

Outpatients with chest pain or possible heart attack who got aspirin within 24 hours of arrival

Here:	99.0%
California:	97.2%

Patients Given a Prescription for a Statin at Discharge

Here:	33.0%
California:	97.5%

Heart Failure

Percent of patients who were given an evaluation of Left Ventricular Systolic Dysfunction (LVSD)

Here:	85.0%
California:	98.9%

Percent of Patients Given ACE Inhibitor or ARB for Left Ventricular Systolic Dysfunction (LVSD)

Here:	98.0%
State:	96.2%

Percent of Patients Given Discharge Instructions

Here:	98.0%
California:	93.5%

Percent of Patients Given Smoking Cessation Advice/Counseling

Here:	100.0%
State:	99.4%

Pneumonia

Percent of Patients Given Initial Antibiotic(s) within 6 Hours After Arrival

Here:	95.0%
California:	96.1%

Percent of Patients Whose Initial ER Blood Culture Was Performed Prior To Administration Of First Dose Of Antibiotics

This Nursing Home:	92.0%
State:	96.7%

Percent of Patients Given Smoking Cessation Advice/Counseling

Here:	100.0%
California:	98.1%

Percent of Patients Given the Most Appropriate Initial Antibiotic(s)

This Nursing Home:	98.0%
California:	95.9%

Percent of Patients Assessed and Given Influenza Vaccination

Here:	94.0%
California:	94.3%

Percent of Patients Assessed and Given Pneumococcal Vaccination

This Nursing Home:	97.0%
California:	95.8%

Surgery

Percent of Surgery Patients given an antibiotic at the right time (within one hour before surgery) to help prevent infection

This Nursing Home:	86.0%
State:	98.1%

Percent of Surgery Patients whose preventive antibiotics were stopped at the right time (within 24 hours after surgery)

This Nursing Home:	92.0%
California:	96.3%

Percent of Surgery Patients who were given the right kind of antibiotic to help prevent infection

This Nursing Home:	81.0%
California:	98.2%

Percent of Surgery Patients who got treatment at right time (within 24 hours before or after surgery) to help prevent blood clot

This Nursing Home:	92.0%
State:	96.0%

Percent of Surgery Patients whose doctors ordered treatments to prevent blood clots after certain types of surgeries

Here:	100.0%
California:	96.9%

Percent of Surgery Patients needing hair removed from the surgical area before surgery who had hair removed using a safer method

Here:	100.0%
California:	99.8%

Percent of Surgery Patients whose urinary catheters were removed on the first or second day after surgery

This Nursing Home:	89.0%
California:	93.9%

Surgery patients who were taking heart drugs called beta blockers before coming to the hospital, who were kept on them

This Nursing Home:	76.0%
State:	96.1%

Patients having surgery who were actively warmed in the operating room or whose body temperature was near normal

This Nursing Home:	100.0%
State:	99.6%

Outcome of Care

30-Day Mortality Rates from Heart Attack

Here:	17.0%
California:	14.9%

30-Day Mortality Rates from Heart Failure

Here:	13.2%
California:	10.9%

30-Day Mortality Rates from Pneumonia

This Nursing Home:	14.1%
State:	11.7%

30-Day Readmission Rates from Heart Failure

Here:	22.5%
California:	24.4%

30-Day Readmission Rates from Pneumonia

This Nursing Home:	19.8%
State:	18.3%

Hospital Acquired Conditions

Falls and injuries

Here:	0.525%
State:	0.625%

Blood infection from a catheter in a large vein

This Nursing Home:	1.576%
State:	0.530%

Complaint Deficiency

Corridor and hallway doors that block smoke
- Harm: Minimal harm or potential for actual harm
- Scope: Few
An approved installation, maintenance and testing program for fire alarm systems
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Automatic sprinkler systems that have been maintained in working order
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Portable fire extinguishers
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Heating and ventilation systems that have been properly installed according to the manufacturer's instructions
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Weekly inspections and monthly testing of generators
- Harm: Potential for minimal harm
- Scope: Many
Properly installed electrical wiring and equipment
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Let the resident refuse treatment or refuse to take part in an experiment and formulate advance directives
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Try to resolve each resident's complaints quickly
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Tell the resident or the resident's representative in writing how long the nursing home will hold the resident's bed
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Develop policies that prevent mistreatment, neglect, or abuse of residents or theft of resident property
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Provide care for residents in a way that keeps or builds each resident's dignity and respect of individuality
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Reasonably accommodate the needs and preferences of each resident
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Provide housekeeping and maintenance services
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Make sure that the nursing home area is free from accident hazards and risks and provides supervision to prevent avoidable accidents
- Harm: Minimal harm or potential for actual harm
- Scope: Few
1) Make sure that each resident's drug regimen is free from unnecessary drugs; 2) Each resident's entire drug/medication is managed and monitored to achieve highest well being
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Develop policies and procedures for influenza and pneumococcal immunizations
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Post nurse staffing information/data on a daily basis
- Harm: Potential for minimal harm
- Scope: Many
Store, cook, and serve food in a safe and clean way
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Have a program that investigates, controls and keeps infection from spreading
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Put firmly secured handrails on each side of hallways
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Operate and provide services according to Federal, State, and local laws and professional standards
- Harm: Minimal harm or potential for actual harm
- Scope: Many
Provide medically-related social services to help each resident achieve the highest possible quality of life
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Make sure services provided by the nursing facility meet professional standards of quality
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Provide necessary care and services to maintain the highest well being of each resident
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Assist those residents who need total help with eating/drinking, grooming and personal and oral hygiene
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature
- Harm: Minimal harm or potential for actual harm
- Scope: Many
Provide food in a way that meets a resident's needs
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Store, cook, and serve food in a safe and clean way
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Have a program that investigates, controls and keeps infection from spreading
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Keep accurate, complete and organized clinical records on each resident that meet professional standards
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Approved construction type or materials
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Corridor and hallway doors that block smoke
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Smoke barrier doors that can resist smoke for at least 20 minutes
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Did not have a written emergency evacuation plan
- Harm: Minimal harm or potential for actual harm
- Scope: Many
Properly maintained smoke detectors
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Proper medical gas storage and administration areas
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Listen to the resident or family groups or act on their complaints or suggestions
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Reasonably accommodate the needs and preferences of each resident
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Provide necessary care and services to maintain the highest well being of each resident
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores
- Harm: Minimal harm or potential for actual harm
- Scope: Few
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
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Have a program that investigates, controls and keeps infection from spreading
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Keep accurate, complete and organized clinical records on each resident that meet professional standards
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Corridors that are separated from common areas by walls constructed to limit the passage of smoke
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Smoke barrier doors that can resist smoke for at least 20 minutes
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Construction that can resist fire for one hour or an approved fire extinguishing system
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Properly located and lighted Exit signs
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Record of quarterly fire drills for each shift under varying conditions
- Harm: Minimal harm or potential for actual harm
- Scope: Few
An approved installation, maintenance and testing program for fire alarm systems
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Portable fire extinguishers
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Heating and ventilation systems that have been properly installed according to the manufacturer's instructions
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Properly installed electrical wiring and equipment
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Properly installed hallway dispensers for alcohol-based hand rub
- Harm: Minimal harm or potential for actual harm
- Scope: Few

Use of Medical Imaging

Outpatients who had a follow-up mammogram or ultrasound within 45 days after a screening mammogram.

Here:	10.900%
State:	8.180%

Outpatient CT scans of the abdomen that were combination (double) scans.

Here:	0.102%
State:	0.170%

Outpatient CT scans of the chest that were combination (double) scans.

Here:	0.163%
California:	0.043%

Outpatients with brain CT scans who got a sinus CT scan at the same time

Here:	2.200%
State:	1.898%

Inpatient Prospective Payment System (IPPS) - Medicare Provider Charge Data

Cardiac Arrhythmia and Conduction Disorders without Complications

Average Covered Charges

Here:	$19,277
State:	$28,713

Average Total Payments

This Nursing Home:	$4,738
State:	$4,819

Number of discharges: 12

Here:	2.64%
California:	1.18%

Cellulitis without Major Complications

Average Covered Charges

This Nursing Home:	$27,202
State:	$36,707

Average Total Payments

This Nursing Home:	$6,953
California:	$7,245

Number of discharges: 18

This Nursing Home:	3.96%
California:	2.08%

Chest Pain

Average Covered Charges

This Nursing Home:	$18,410
State:	$29,034

Average Total Payments

This Nursing Home:	$4,564
California:	$4,742

Number of discharges: 17

Here:	3.74%
State:	2.11%

Chronic Obstructive Pulmonary Disease with Complications

Average Covered Charges

Here:	$29,739
California:	$46,809

Average Total Payments

This Nursing Home:	$7,991
State:	$8,290

Number of discharges: 18

Here:	3.96%
California:	1.75%

Chronic Obstructive Pulmonary Disease with Major Complications

Average Covered Charges

This Nursing Home:	$29,122
State:	$58,013

Average Total Payments

Here:	$9,724
State:	$10,305

Number of discharges: 21

Here:	4.62%
California:	2.00%

Chronic Obstructive Pulmonary Disease without Complications

Average Covered Charges

Here:	$26,460
State:	$35,163

Average Total Payments

Here:	$5,981
State:	$6,206

Number of discharges: 16

This Nursing Home:	3.52%
State:	1.11%

Esophagitis, Gastroent and Miscellaneous Digestive Disorders without Major Complications

Average Covered Charges

Here:	$22,319
State:	$36,899

Average Total Payments

Here:	$6,033
State:	$6,233

Number of discharges: 11

This Nursing Home:	2.42%
State:	3.09%

G.I. Hemorrhage with Complications

Average Covered Charges

Here:	$22,434
California:	$46,039

Average Total Payments

This Nursing Home:	$7,991
State:	$8,685

Number of discharges: 15

Here:	3.30%
California:	1.95%

Heart Failure and Shock with Complications

Average Covered Charges

Here:	$22,662
State:	$47,292

Average Total Payments

Here:	$8,382
State:	$8,831

Number of discharges: 24

Here:	5.27%
California:	2.91%

Heart Failure and Shock with Major Complications

Average Covered Charges

This Nursing Home:	$30,902
State:	$70,963

Average Total Payments

Here:	$12,324
State:	$13,159

Number of discharges: 25

Here:	5.49%
State:	3.03%

Hip and Femur Procedures Except Major Joint with Complications

Average Covered Charges

Here:	$47,688
State:	$88,197

Average Total Payments

Here:	$15,649
California:	$15,201

Number of discharges: 11

Here:	2.42%
California:	1.05%

Intracranial Hemorrhage or Cerebral Infarction with Complications

Average Covered Charges

Here:	$34,237
State:	$55,669

Average Total Payments

Here:	$9,683
California:	$9,837

Number of discharges: 17

This Nursing Home:	3.74%
California:	1.65%

Intracranial Hemorrhage or Cerebral Infarction without Complications

Average Covered Charges

This Nursing Home:	$24,301
California:	$42,438

Average Total Payments

Here:	$6,804
State:	$6,978

Number of discharges: 13

This Nursing Home:	2.86%
State:	0.78%

Kidney and Urinary Tract Infections without Major Complications

Average Covered Charges

This Nursing Home:	$23,627
State:	$36,114

Average Total Payments

Here:	$6,527
State:	$6,728

Number of discharges: 21

This Nursing Home:	4.62%
California:	2.98%

Major Joint Replacement or Reattachment of Lower Extremity without Major Complications

Average Covered Charges

Here:	$36,251
California:	$88,239

Average Total Payments

This Nursing Home:	$17,393
State:	$17,187

Number of discharges: 28

Here:	6.15%
State:	6.26%

Misc Disorders of Nutrition, Metabolism, Fluids or Electrolytes without Major Complications

Average Covered Charges

This Nursing Home:	$20,238
California:	$32,446

Average Total Payments

This Nursing Home:	$5,740
California:	$5,975

Number of discharges: 14

This Nursing Home:	3.08%
California:	2.21%

Pulmonary Edema and Respiratory Failure

Average Covered Charges

Here:	$40,961
State:	$64,758

Average Total Payments

Here:	$10,631
State:	$11,179

Number of discharges: 13

Here:	2.86%
California:	1.15%

Renal Failure with Complications

Average Covered Charges

This Nursing Home:	$24,765
California:	$48,439

Average Total Payments

Here:	$8,376
California:	$8,967

Number of discharges: 16

This Nursing Home:	3.52%
State:	1.90%

Renal Failure with Major Complications

Average Covered Charges

This Nursing Home:	$33,838
California:	$72,128

Average Total Payments

Here:	$13,365
State:	$14,548

Number of discharges: 13

Here:	2.86%
State:	1.48%

Respiratory System Diagnosis with Ventilator Support <96 Hours

Average Covered Charges

This Nursing Home:	$62,917
State:	$120,888

Average Total Payments

This Nursing Home:	$18,782
State:	$21,006

Number of discharges: 15

This Nursing Home:	3.30%
California:	0.92%

Septicemia or Severe Sepsis without Mechanical Ventilation 96+ Hours with Major Complications

Average Covered Charges

This Nursing Home:	$46,148
State:	$90,173

Average Total Payments

Here:	$15,389
State:	$16,748

Number of discharges: 35

Here:	7.69%
California:	7.21%

Septicemia or Severe Sepsis without Mechanical Ventilation 96+ Hours without Major Complications

Average Covered Charges

This Nursing Home:	$29,312
State:	$50,385

Average Total Payments

This Nursing Home:	$8,378
California:	$9,612

Number of discharges: 15

Here:	3.30%
California:	2.35%

Simple Pneumonia and Pleurisy with Complications

Average Covered Charges

This Nursing Home:	$28,976
California:	$48,755

Average Total Payments

Here:	$8,350
California:	$8,695

Number of discharges: 30

This Nursing Home:	6.59%
State:	2.75%

Simple Pneumonia and Pleurisy with Major Complications

Average Covered Charges

Here:	$29,597
California:	$70,362

Average Total Payments

Here:	$12,280
State:	$12,496

Number of discharges: 17

This Nursing Home:	3.74%
California:	1.89%

Simple Pneumonia and Pleurisy without Complications

Average Covered Charges

This Nursing Home:	$24,176
State:	$34,477

Average Total Payments

Here:	$5,873
State:	$5,838

Number of discharges: 20

Here:	4.40%
State:	0.97%

Staff Information

Number of Registered Nurses Hours Per Resident Per Day

Here:	0.720
California:	0.748

Total Number of Licensed Staff Hours Per Resident Per Day

This Nursing Home:	0.720
California:	1.608

Number of ,Certified Nurse Assistant Hours Per Resident Per Day

This Nursing Home:	0.040
State:	0.118

Number Therapy Hours Per Resident Per Day

Here:	0.040
State:	0.126

Quality Measures

Percent of long-stay residents whose need for help with daily activities has increased

This Nursing Home:	28.4%
California:	13.1%

Percent of long-stay residents who self-report moderate to severe pain

Here:	24.8%
California:	8.9%

Percent of long-stay high-risk residents with pressure ulcers

This Nursing Home:	4.5%
State:	7.5%

Percent of long-stay residents who lose too much weight

This Nursing Home:	6.6%
State:	6.3%

Percent of long-stay low-risk residents who lose control of their bowels or bladder

This Nursing Home:	25.8%
California:	42.7%

Percent of long-stay residents who have had a catheter inserted and left in their bladder

This Nursing Home:	9.6%
State:	4.0%

Percent of long-stay residents with a urinary tract infection

This Nursing Home:	2.2%
State:	6.7%

Percent of long-stay residents who have depressive symptoms

Here:	5.3%
California:	2.4%

Percent of long-stay residents who were physically restrained

This Nursing Home:	1.1%
State:	3.6%

Percent of long-stay residents experiencing one or more falls with major injury

This Nursing Home:	1.1%
State:	1.6%

Percent of long-stay residents assessed and given, appropriately, the seasonal influenza vaccine

Here:	100.0%
State:	93.0%

Percent of long-stay residents assessed and given, appropriately, the pneumococcal vaccine

Here:	97.8%
State:	94.0%

Percent of short-stay residents who self-report moderate to severe pain

This Nursing Home:	38.8%
State:	21.2%

Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine

Here:	100.0%
California:	81.9%

Percent of short-stay residents assessed and given, appropriately, the pneumococcal vaccine

Here:	99.3%
State:	79.7%

Percent of short-stay residents who newly received an antipsychotic medication

This Nursing Home:	1.2%
State:	2.2%

Percent of long-stay residents who received an antipsychotic medication

Here:	7.8%
State:	19.0%

Hospital Consumer Assessment of Healthcare Providers

Number of Completed Surveys:: 300 or more
Survey Response Rate: 26%

How often did nurses communicate well with patients?

Sometimes or never

Here:	6%
California:	7%

Usually

This Nursing Home:	19%
California:	21%

Always

Here:	75%
State:	72%

How often did doctors communicate well with patients?

Sometimes or never

Here:	11%
California:	6%

Usually

This Nursing Home:	19%
State:	17%

Always

This Nursing Home:	70%
California:	77%

How often did patients receive help quickly from hospital staff?

Sometimes or never

This Nursing Home:	11%
State:	13%

Usually

This Nursing Home:	31%
California:	28%

Always

Here:	58%
California:	59%

How often was patients' pain well controlled?

Sometimes or never

Here:	10%
State:	8%

Usually

This Nursing Home:	21%
California:	25%

Always

Here:	69%
State:	67%

How often did staff explain about medicines before giving them to patients?

Sometimes or never

Here:	25%
California:	23%

Usually

Here:	21%
State:	19%

Always

Here:	54%
California:	58%

How often were the patients' rooms and bathrooms kept clean?

Sometimes or never

This Nursing Home:	13%
California:	10%

Usually

This Nursing Home:	25%
State:	21%

Always

This Nursing Home:	62%
State:	69%

How often was the area around patients' rooms kept quiet at night?

Sometimes or never

This Nursing Home:	13%
State:	18%

Usually

This Nursing Home:	34%
California:	33%

Always

This Nursing Home:	53%
California:	49%

Were patients given information about what to do during their recovery at home?

Yes

This Nursing Home:	74%
State:	81%

This Nursing Home:	26%
California:	19%

How do patients rate the hospital overall on a scale from 0 (lowest) to 10 (highest)?

6 or lower

This Nursing Home:	16%
California:	10%

7 or 8

This Nursing Home:	22%
California:	24%

9 or 10

This Nursing Home:	62%
California:	66%

Would patients recommend the hospital to friends and family?

This Nursing Home:	10%
California:	7%

Yes, probably

Here:	31%
State:	24%

Yes, definitely

This Nursing Home:	59%
State:	69%

HI-DESERT MEDICAL CENTER D/P SNF - JOSHUA TREE, CA

Process of Care

Heart Attack

Heart Failure

Pneumonia

Surgery

Outcome of Care

Hospital Acquired Conditions

Complaint Deficiency

Use of Medical Imaging

Inpatient Prospective Payment System (IPPS) - Medicare Provider Charge Data

Staff Information

Quality Measures

Hospital Consumer Assessment of Healthcare Providers

User Contributions:

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