Arroyo Grande Community Hospital

Total Number of Beds: 12	Percent of Occupied Beds: 67%
Total Number of Residents: 8	Located Within a Hospital: Yes
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 12/05/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day:

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

Number of CNA Hours per Nursing Home Resident per Day:

Number of Staff Hours per Nursing Home Resident per Day:

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 45%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 36%
Percent of Short-Stay Residents With Delirium: 14%
** Details Last Reported on: 12/5/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-10-04	2001-11-19	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
2001-10-04	2001-11-19	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2001-10-04	2001-11-19	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
2001-10-04	2001-11-19	Pharmacy Service Deficiencies	1) Make sure that residents who take drugs are not given too many doses or for too long; 2) make sure that the use of drugs is carefully watched; or 3) stop or change drugs that cause unwanted effects.	Isolated	Minimal harm or potential for actual harm
2001-10-04	2001-11-19	Nutrition and Dietary Deficiencies	Make sure that the attending doctor orders special diets.	Isolated	Minimal harm or potential for actual harm
2001-10-04	2001-11-19	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
2002-11-15	2002-11-24	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Widespread	Potential for minimal harm
2002-11-15	2002-12-22	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Widespread	Potential for minimal harm
2002-11-15	2002-12-22	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
2002-11-15	2002-12-22	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Isolated	Minimal harm or potential for actual harm
2002-11-15	2002-12-04	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
2002-11-15	2002-12-04	Environmental Deficiencies	Get rid of garbage properly.	Widespread	Potential for minimal harm
2002-11-15	2002-12-22	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2002-11-15	2002-12-22	Administration Deficiencies	Have a detailed, written plan for disasters and emergencies.	Widespread	Potential for minimal harm
2003-12-05	2004-01-05	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Isolated	Minimal harm or potential for actual harm
2003-12-05	2004-01-05	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Pattern	Potential for minimal harm
2003-12-05	2004-01-05	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Potential for minimal harm
2003-12-05	2004-01-05	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Isolated	Minimal harm or potential for actual harm

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