| Total Number of Beds: 111 | Percent of Occupied Beds: 69% |
| Total Number of Residents: 77 | Located Within a Hospital: No |
| Type of Ownership: Non profit - Corporation | Multiple Nursing Homes by Same Owner: Yes |
| Councils the Nursing Home Participates in: Resident | Medicare/Medicaid: Participating in Medicare and Medicaid |
| * Details Last Reported on: 05/30/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-09-21 |
2001-10-26 |
Resident Rights Deficiencies |
Have a private telephone available for use. |
Widespread |
Potential for minimal harm |
| 2001-09-21 |
2001-10-26 |
Environmental Deficiencies |
Provide needed housekeeping and maintenance. |
Widespread |
Potential for minimal harm |
| 2001-09-21 |
2001-10-26 |
Environmental Deficiencies |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-09-21 |
2001-10-26 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| 2001-09-21 |
2001-09-22 |
Environmental Deficiencies |
Have a program to keep infection from spreading. |
Widespread |
Immediate jeopardy to resident health or safety |
| 2001-09-21 |
2001-10-26 |
Environmental Deficiencies |
Make sure there is a program to prevent/deal with mice, insects, or other pests. |
Pattern |
Minimal harm or potential for actual harm |
| 2001-09-21 |
2001-10-26 |
Administration Deficiencies |
Give or get lab tests to meet the needs of residents. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-07-31 |
2002-08-02 |
Quality Care Deficiencies |
Make sure that residents with loss of bladder control receive treatment or service to prevent infections and help get normal bladder control. |
Isolated |
Actual harm |
| 2003-05-30 |
2003-06-06 |
Mistreatment Deficiencies |
Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property. |
Widespread |
Immediate jeopardy to resident health or safety |
| 2003-05-30 |
2003-06-06 |
Environmental Deficiencies |
Have a program to keep infection from spreading. |
Pattern |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.