Ebenezer Covenant Village

Total Number of Beds: 65	Percent of Occupied Beds: 97%
Total Number of Residents: 63	Located Within a Hospital: No
Type of Ownership: Non profit - Church related	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: 10/31/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.44

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.42

Number of CNA Hours per Nursing Home Resident per Day: 0.32

Number of Staff Hours per Nursing Home Resident per Day: 1.18

Nursing Home Resident Information**:

Percent of High-Risk Residents Who Have Pressure Sores: 5%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 26%
Percent of Residents Who Have Moderate to Severe Pain: 3%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 12%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 0%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 18%
Percent of Residents Who are More Depressed or Anxious: 9%
Percent of Short-Stay Residents With Delirium: 4%
Percent of Residents Who Were Physically Restrained: 0%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 73%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 4%
Percent of Residents With a Urinary Tract Infection: 5%
** Details Last Reported on: 10/31/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-03-07	2002-04-05	Resident Rights Deficiencies	Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged.	Isolated	Actual harm
2002-03-07	2002-04-05	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Actual harm
2003-01-09	2003-03-11	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Pattern	Minimal harm or potential for actual harm
2003-01-09	2003-03-11	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
2003-01-09	2003-03-11	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
2003-01-09	2003-03-11	Quality Care Deficiencies	Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.	Isolated	Minimal harm or potential for actual harm
2003-10-31	2003-12-08	Resident Assessment Deficiencies	Check and update (if needed) each resident's assessment every 3 months.	Isolated	Minimal harm or potential for actual harm
2003-10-31	2003-12-08	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
2003-10-31	2003-12-08	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

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