Stafholt Good Samaritan Center

Total Number of Beds: 57	Percent of Occupied Beds: 100%
Total Number of Residents: 57	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: 04/03/2003

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 High-Risk Residents Who Have Pressure Sores: 0%
Percent of Residents Who Have Moderate to Severe Pain: 7%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 21%
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: 29%
Percent of Residents Who are More Depressed or Anxious: 14%
Percent of Residents Who Were Physically Restrained: 4%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 62%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 0%
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
2001-03-16	2001-04-26	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.	Isolated	Minimal harm or potential for actual harm
2001-03-16	2001-04-26	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
2001-03-16	2001-04-26	Quality Care Deficiencies	Give each resident enough fluids to keep them healthy and prevent dehydration.	Isolated	Minimal harm or potential for actual harm
2001-03-16	2001-04-26	Quality Care Deficiencies	Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	Isolated	Minimal harm or potential for actual harm
2001-03-16	2001-04-26	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
2002-04-12	0000-00-00	Resident Rights Deficiencies	Have a private telephone available for use.	Pattern	Potential for minimal harm
2002-04-12	0000-00-00	Environmental Deficiencies	Keep sound levels comfortable.	Pattern	Potential for minimal harm
2002-04-12	0000-00-00	Quality Care Deficiencies	Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion.	Pattern	Minimal harm or potential for actual harm
2002-04-12	2002-06-04	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
2003-04-03	2003-05-22	Resident Rights Deficiencies	Tell the resident completely about his or her health status.	Pattern	Minimal harm or potential for actual harm
2003-04-03	2003-06-16	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	2003-05-22	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Pattern	Minimal harm or potential for actual harm

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