Country Care Convalescent Hospital

Total Number of Beds: 60	Percent of Occupied Beds: 92%
Total Number of Residents: 55	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: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 12/11/2003

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 Residents Who Have Moderate to Severe Pain: 34%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 10%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 13%
Percent of Residents Who are More Depressed or Anxious: 21%
Percent of Residents Who Were Physically Restrained: 16%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 2%
Percent of Residents With a Urinary Tract Infection: 8%
** Details Last Reported on: 12/11/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-10-04	2001-10-24	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Isolated	Minimal harm or potential for actual harm
2001-10-04	2001-10-24	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	2001-10-24	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2001-10-04	2001-10-24	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Pattern	Minimal harm or potential for actual harm
2001-10-04	2001-10-24	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
2002-11-25	2002-12-31	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Isolated	Minimal harm or potential for actual harm
2002-11-25	2003-01-03	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Widespread	Potential for minimal harm
2002-11-25	2002-12-31	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
2002-11-25	2003-01-06	Pharmacy Service Deficiencies	Gradually lower the dose of residents' antipsychotic drugs, unless this causes negative medical effects.	Isolated	Minimal harm or potential for actual harm
2002-11-25	2002-12-20	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2002-11-25	2002-12-12	Environmental Deficiencies	Provide rooms that are big enough for each resident.	Widespread	Potential for minimal harm
2003-12-11	2004-01-25	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2003-12-11	2004-01-08	Resident Assessment Deficiencies	Provide a final summary of the resident's health status and a summary of the resident's stay, when the resident is ready to leave the nursing home.	Pattern	Potential for minimal harm
2003-12-11	2004-01-25	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
2003-12-11	2004-01-08	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Pattern	Potential for minimal harm
2003-12-11	2004-01-08	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
2003-12-11	2003-12-12	Environmental Deficiencies	Provide rooms that are big enough for each resident.	Pattern	Potential for minimal harm

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