| Total Number of Beds: 120 | Percent of Occupied Beds: 98% |
| Total Number of Residents: 117 | Located Within a Hospital: No |
| Type of Ownership: Non 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: 12/11/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-10-12 |
2001-12-27 |
Pharmacy Service Deficiencies |
Properly mark drugs and other similar products. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-11-07 |
2003-01-14 |
Pharmacy Service Deficiencies |
Properly mark drugs and other similar products. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-11-07 |
2003-01-14 |
Environmental Deficiencies |
Have a program to keep infection from spreading. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-12-11 |
2004-01-22 |
Quality Care Deficiencies |
Provide activities to meet the needs of each resident. |
Pattern |
Minimal harm or potential for actual harm |
| 2003-12-11 |
2004-01-22 |
Environmental Deficiencies |
Keep safe, clean and homelike surroundings. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-12-11 |
2004-01-22 |
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 |
| 2003-12-11 |
2004-01-22 |
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 |
| 2003-12-11 |
2004-01-22 |
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 |
| 2003-12-11 |
2004-01-22 |
Quality Care Deficiencies |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-12-11 |
2004-01-22 |
Administration Deficiencies |
Keep accurate and appropriate medical records. |
Isolated |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.