Alliance Good Samaritan Villag

Total Number of Beds: 77	Percent of Occupied Beds: 94%
Total Number of Residents: 72	Located Within a Hospital: No
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 05/29/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.56

Number of LPN/LVN Hours per Nursing Home Resident per Day: 1.17

Number of CNA Hours per Nursing Home Resident per Day: 2.21

Number of Staff Hours per Nursing Home Resident per Day: 3.94

Nursing Home Resident Information**:

Percent of Low-Risk Residents Who Have Pressure Sores: 10%
Percent of Residents Who Have Moderate to Severe Pain: 8%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 24%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 0%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 30%
Percent of Residents Who are More Depressed or Anxious: 14%
Percent of Residents Who Were Physically Restrained: 4%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 30%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 7%
Percent of Residents With a Urinary Tract Infection: 4%
** Details Last Reported on: 5/29/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-04-06	2001-06-05	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Pattern	Minimal harm or potential for actual harm
2001-04-06	2001-06-05	Resident Assessment Deficiencies	1) Develop a complete care plan within 7 days of each resident's admission; 2) prepare a care plan with the care team, including the primary nurse, doctor, resident or resident's family or representative; or 3) check and update the care plan.	Pattern	Minimal harm or potential for actual harm
2001-04-06	2001-06-05	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Minimal harm or potential for actual harm
2002-05-14	2002-06-27	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Widespread	Potential for minimal harm
2002-05-14	2002-06-27	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2002-05-14	2002-06-27	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2003-05-29	2003-08-05	Resident Rights Deficiencies	Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged.	Isolated	Minimal harm or potential for actual harm
2003-05-29	2003-08-05	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2003-05-29	2003-08-05	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2003-05-29	2003-08-05	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
2003-05-29	2003-08-05	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
2003-05-29	2003-08-05	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2003-05-29	2003-08-05	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Actual harm
2003-05-29	2003-08-05	Pharmacy Service Deficiencies	Make sure that the pharmacist reports anything unusual to the doctor on duty and the director of nursing.	Isolated	Minimal harm or potential for actual harm
2003-05-29	2003-08-05	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Widespread	Minimal harm or potential for actual harm

*** All violations listed are based on federal government records.