Sioux Valley Canby Campus

Total Number of Beds: 75	Percent of Occupied Beds: 93%
Total Number of Residents: 70	Located Within a Hospital: Yes
Type of Ownership: Non 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: 04/15/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.55

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.43

Number of CNA Hours per Nursing Home Resident per Day: 2.44

Number of Staff Hours per Nursing Home Resident per Day: 3.42

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 12%
Percent of High-Risk Residents Who Have Pressure Sores: 11%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 28%
Percent of Residents Who Have Moderate to Severe Pain: 4%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 14%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 2%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 21%
Percent of Residents Who are More Depressed or Anxious: 19%
Percent of Short-Stay Residents With Delirium: 0%
Percent of Residents Who Were Physically Restrained: 0%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 47%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 6%
Percent of Residents With a Urinary Tract Infection: 11%
** Details Last Reported on: 4/15/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-01-09	2001-02-28	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
2001-01-09	2001-01-09	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
2001-01-09	2001-02-28	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
2002-03-28	2002-06-14	Nutrition and Dietary Deficiencies	Make sure that the attending doctor orders special diets.	Pattern	Minimal harm or potential for actual harm
2003-04-15	2003-06-02	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2003-04-15	2003-06-02	Pharmacy Service Deficiencies	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Pattern	Minimal harm or potential for actual harm
2003-04-15	2003-06-02	Environmental Deficiencies	Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection.	Widespread	Potential for minimal harm

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