Surrey Place Convalescent Center

Total Number of Beds: 60	Percent of Occupied Beds: 92%
Total Number of Residents: 55	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 06/12/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.84

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.7

Number of CNA Hours per Nursing Home Resident per Day: 2.58

Number of Staff Hours per Nursing Home Resident per Day: 4.12

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 23%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 20%
Percent of Residents Who Have Moderate to Severe Pain: 11%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 14%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 23%
Percent of Residents Who are More Depressed or Anxious: 15%
Percent of Short-Stay Residents With Delirium: 0%
Percent of Residents Who Were Physically Restrained: 2%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 6%
Percent of Residents With a Urinary Tract Infection: 17%
** Details Last Reported on: 6/12/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-08-15	2001-09-15	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
2001-08-15	2001-09-15	Pharmacy Service Deficiencies	Make sure that the pharmacist reports anything unusual to the doctor on duty and the director of nursing.	Isolated	Minimal harm or potential for actual harm
2002-05-16	2002-06-18	Quality Care Deficiencies	Give each resident enough fluids to keep them healthy and prevent dehydration.	Pattern	Minimal harm or potential for actual harm
2002-05-16	2002-06-18	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2003-06-12	2003-07-15	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2003-06-12	2003-07-15	Quality Care Deficiencies	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Isolated	Minimal harm or potential for actual harm
2003-06-12	2003-07-15	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
2003-06-12	2003-07-15	Resident Assessment Deficiencies	Do a new assessment after any major change in a resident's physical or mental health.	Isolated	Minimal harm or potential for actual harm
2003-06-12	2003-07-15	Resident Assessment Deficiencies	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Isolated	Minimal harm or potential for actual harm
2003-06-12	2003-07-15	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
2003-06-12	2003-07-15	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.	Pattern	Minimal harm or potential for actual harm
2003-06-12	2003-07-15	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2003-06-12	2003-07-15	Nutrition and Dietary Deficiencies	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Isolated	Minimal harm or potential for actual harm
2003-06-12	2003-07-15	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2003-06-12	2003-07-15	Environmental Deficiencies	Get rid of garbage properly.	Widespread	Minimal harm or potential for actual harm

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