Centerville Good Samaritan

Total Number of Beds: 45	Percent of Occupied Beds: 91%
Total Number of Residents: 41	Located Within a Hospital: No
Type of Ownership: Non profit - Corporation	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: 04/02/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.83

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.04

Number of CNA Hours per Nursing Home Resident per Day: 1.85

Number of Staff Hours per Nursing Home Resident per Day: 2.72

Nursing Home Resident Information**:

Percent of Residents Who Have Moderate to Severe Pain: 7%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 8%
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: 22%
Percent of Residents Who are More Depressed or Anxious: 32%
Percent of Residents Who Were Physically Restrained: 2%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 48%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 8%
Percent of Residents With a Urinary Tract Infection: 11%
** Details Last Reported on: 4/2/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-04-05	2001-06-05	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Isolated	Minimal harm or potential for actual harm
2001-04-05	2001-06-05	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2001-04-05	2001-06-05	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2001-04-05	2001-06-05	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
2002-05-15	2002-07-12	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Isolated	Minimal harm or potential for actual harm
2003-04-02	2003-05-27	Quality Care Deficiencies	Give proper treatment to residents with feeding tubes to prevent problems (such as aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, nasal-pharyngeal ulcers) and help restore eating skills, if possible.	Isolated	Minimal harm or potential for actual harm
2003-04-02	2003-05-27	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Widespread	Potential for minimal harm

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