Colonial Villa Good Samaritan

Total Number of Beds: 53	Percent of Occupied Beds: 91%
Total Number of Residents: 48	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: 07/08/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.69

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.33

Number of CNA Hours per Nursing Home Resident per Day: 2.36

Number of Staff Hours per Nursing Home Resident per Day: 3.38

Nursing Home Resident Information**:

Percent of High-Risk Residents Who Have Pressure Sores: 10%
Percent of Residents Who Have Moderate to Severe Pain: 3%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 2%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 16%
Percent of Residents Who are More Depressed or Anxious: 15%
Percent of Residents Who Were Physically Restrained: 0%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 4%
Percent of Residents With a Urinary Tract Infection: 2%
** Details Last Reported on: 7/8/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-06-15	2002-07-15	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2002-06-15	2002-07-15	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
2002-06-15	2002-07-15	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
2003-07-08	2003-08-25	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm

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