Id Elks Rehab and Sa Hospital

Total Number of Beds: 12	Percent of Occupied Beds: 100%
Total Number of Residents: 12	Located Within a Hospital: Yes
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 12/03/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 1.97

Number of LPN/LVN Hours per Nursing Home Resident per Day: 2.37

Number of CNA Hours per Nursing Home Resident per Day: 3.62

Number of Staff Hours per Nursing Home Resident per Day: 7.96

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 17%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 52%
Percent of Short-Stay Residents With Delirium: 13%
** Details Last Reported on: 12/3/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-10-11	2001-11-15	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2001-10-11	2001-11-15	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
2001-10-11	2001-11-15	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Isolated	Minimal harm or potential for actual harm
2003-12-03	2004-01-07	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2003-12-03	2004-01-07	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
2003-12-03	2004-01-07	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
2003-12-03	2004-01-07	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
2003-12-03	2004-01-07	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
2003-12-03	2004-01-07	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2003-12-03	2004-01-07	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm

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