Pelican Lake Health Care Center

Total Number of Beds: 58	Percent of Occupied Beds: 93%
Total Number of Residents: 54	Located Within a Hospital: No
Type of Ownership: Non profit - Other	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 02/04/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.31

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.88

Number of CNA Hours per Nursing Home Resident per Day: 1.94

Number of Staff Hours per Nursing Home Resident per Day: 3.13

Nursing Home Resident Information**:

Percent of High-Risk Residents Who Have Pressure Sores: 3%
Percent of Residents Who Have Moderate to Severe Pain: 3%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 13%
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: 15%
Percent of Residents Who are More Depressed or Anxious: 30%
Percent of Residents Who Were Physically Restrained: 16%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 5%
Percent of Residents With a Urinary Tract Infection: 8%
** Details Last Reported on: 2/4/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-02-22	2001-03-29	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Potential for minimal harm
2001-02-22	2001-03-29	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
2001-11-30	2001-12-14	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
2003-02-04	2003-03-28	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
2003-02-04	2003-03-28	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2003-02-04	2003-03-28	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
2003-02-04	2003-03-28	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2003-02-04	2003-03-28	Environmental Deficiencies	Provide bedrooms that don't allow residents to see each other when privacy is needed.	Pattern	Potential for minimal harm
2003-02-04	2003-03-28	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

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