Clover Manor

Total Number of Beds: 110	Percent of Occupied Beds: 93%
Total Number of Residents: 102	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	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: 04/03/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.89

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.54

Number of CNA Hours per Nursing Home Resident per Day: 2.97

Number of Staff Hours per Nursing Home Resident per Day: 4.4

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 5%
Percent of High-Risk Residents Who Have Pressure Sores: 11%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 44%
Percent of Residents Who Have Moderate to Severe Pain: 2%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 29%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 8%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 14%
Percent of Residents Who are More Depressed or Anxious: 16%
Percent of Short-Stay Residents With Delirium: 7%
Percent of Residents Who Were Physically Restrained: 10%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 59%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 7%
Percent of Residents With a Urinary Tract Infection: 8%
** Details Last Reported on: 4/3/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-06-14	2001-07-29	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
2001-06-14	2001-07-29	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Minimal harm or potential for actual harm
2001-06-14	2001-07-29	Resident Assessment Deficiencies	Do an assessment of the resident every year.	Isolated	Minimal harm or potential for actual harm
2001-06-14	2001-07-29	Resident Assessment Deficiencies	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Isolated	Minimal harm or potential for actual harm
2001-06-14	2001-07-29	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Isolated	Minimal harm or potential for actual harm
2001-06-14	2001-08-01	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
2002-07-12	2002-08-01	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Pattern	Minimal harm or potential for actual harm
2002-07-12	2002-08-01	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Widespread	Potential for minimal harm
2002-07-12	2002-09-15	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Pattern	Minimal harm or potential for actual harm
2002-07-12	2002-09-12	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
2002-07-12	2002-09-15	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
2002-07-12	2002-09-24	Resident Assessment Deficiencies	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Pattern	Potential for minimal harm
2002-07-12	2002-09-24	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Isolated	Minimal harm or potential for actual harm
2002-07-12	2002-09-24	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.	Isolated	Minimal harm or potential for actual harm
2002-07-12	2002-08-26	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2002-07-12	2002-08-15	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2002-07-12	2002-09-24	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Pattern	Minimal harm or potential for actual harm
2002-07-12	2002-08-02	Quality Care Deficiencies	Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.	Pattern	Minimal harm or potential for actual harm
2002-07-12	2002-08-15	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2002-07-12	2002-08-23	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Actual harm
2002-07-12	2002-10-01	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2002-07-12	2002-08-15	Pharmacy Service Deficiencies	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Isolated	Minimal harm or potential for actual harm
2002-07-12	2002-08-23	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
2002-07-12	2002-08-15	Pharmacy Service Deficiencies	Act when the pharmacist reports something unusual.	Isolated	Minimal harm or potential for actual harm
2002-07-12	2002-08-01	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Isolated	Minimal harm or potential for actual harm
2002-07-12	2002-09-15	Environmental Deficiencies	Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection.	Isolated	Minimal harm or potential for actual harm
2002-07-12	2002-09-19	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
2002-07-12	2002-08-15	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
2003-04-03	2003-05-01	Mistreatment Deficiencies	1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents.	Pattern	Minimal harm or potential for actual harm
2003-04-03	2003-05-08	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
2003-04-03	0000-00-00	Resident Assessment Deficiencies	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Pattern	Potential for minimal harm
2003-04-03	0000-00-00	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Isolated	Minimal harm or potential for actual harm
2003-04-03	2003-05-01	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.	Isolated	Minimal harm or potential for actual harm
2003-04-03	2003-05-01	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2003-04-03	2003-05-01	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
2003-04-03	2003-05-01	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2003-04-03	0000-00-00	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.	Pattern	Potential for minimal harm
2003-04-03	2003-05-04	Nutrition and Dietary Deficiencies	1) Provide 3 meals daily at regular times; or 2) serve breakfast within 14 hours after dinner; or 3) offer a snack at bedtime each day.	Pattern	Minimal harm or potential for actual harm
2003-04-03	2003-05-01	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2003-04-03	2003-05-01	Environmental Deficiencies	Be designed, built, equipped, or well kept to protect the health and safety of residents, workers, and the public.	Isolated	Minimal harm or potential for actual harm
2003-04-03	2003-05-01	Administration Deficiencies	Get proof that a nurse aide has the training and skills that the State requires.	Pattern	Minimal harm or potential for actual harm
2003-04-03	2003-05-01	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Minimal harm or potential for actual harm

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