Kings Daughters Hospital Sub

Total Number of Beds: 10	Percent of Occupied Beds: 50%
Total Number of Residents: 5	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: 08/15/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 4.79

Number of LPN/LVN Hours per Nursing Home Resident per Day: 3.84

Number of CNA Hours per Nursing Home Resident per Day: 4.67

Number of Staff Hours per Nursing Home Resident per Day: 13.3

Nursing Home Resident Information**:

** Details Last Reported on: 8/15/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-05-23	2001-06-20	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Widespread	Potential for minimal harm
2001-05-23	2001-07-23	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

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