| Total Number of Beds: 113 | Percent of Occupied Beds: 87% |
| Total Number of Residents: 98 | Located Within a Hospital: No |
| Type of Ownership: Non profit - Church related | Multiple Nursing Homes by Same Owner: No |
| Councils the Nursing Home Participates in: Family & Resident | Medicare/Medicaid: Participating in Medicare and Medicaid |
| * Details Last Reported on: 07/11/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-06-12 |
2001-08-15 |
Resident Assessment Deficiencies |
Make a complete assessment that covers all questions for areas that are listed in official regulations. |
Isolated |
Actual harm |
| 2001-06-12 |
2001-08-15 |
Quality Care Deficiencies |
Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion. |
Isolated |
Actual harm |
| 2001-06-12 |
2001-08-15 |
Environmental Deficiencies |
Have a program to keep infection from spreading. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-06-12 |
2001-08-15 |
Environmental Deficiencies |
Make sure that the nursing home area is safe, easy to use, clean and comfortable. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-06-10 |
2002-07-10 |
Resident Rights Deficiencies |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Pattern |
Potential for minimal harm |
| 2002-06-10 |
2002-07-10 |
Resident Rights Deficiencies |
Provide services to meet the needs and preferences of each resident. |
Pattern |
Potential for minimal harm |
| 2002-06-10 |
2002-07-10 |
Quality Care Deficiencies |
Give each resident care and services to get or keep the highest quality of life possible. |
Pattern |
Potential for minimal harm |
| 2002-06-10 |
2002-07-10 |
Quality Care Deficiencies |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-06-10 |
2002-07-10 |
Administration Deficiencies |
Keep accurate and appropriate medical records. |
Pattern |
Potential for minimal harm |
| 2003-07-11 |
2003-08-11 |
Mistreatment Deficiencies |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Pattern |
Minimal harm or potential for actual harm |
| 2003-07-11 |
2003-08-11 |
Environmental Deficiencies |
Have a program to keep infection from spreading. |
Isolated |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.