| Total Number of Beds: 102 | Percent of Occupied Beds: 67% |
| Total Number of Residents: 68 | 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: 10/09/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-11-01 |
2001-11-26 |
Pharmacy Service Deficiencies |
Provide drugs and related services needed by each resident. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-09-23 |
2002-10-28 |
Environmental Deficiencies |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-09-23 |
2002-10-28 |
Administration Deficiencies |
Keep accurate and appropriate medical records. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-10-09 |
2003-11-05 |
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 |
| 2003-10-09 |
2003-10-10 |
Resident Rights Deficiencies |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-10-09 |
2003-11-20 |
Environmental Deficiencies |
Provide needed housekeeping and maintenance. |
Pattern |
Potential for minimal harm |
| 2003-10-09 |
2003-10-23 |
Quality Care Deficiencies |
Give each resident a special diet to help when there is a nutritional problem. |
Isolated |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.