Memorial Hospital Skilled Nursing Facility

Total Number of Beds: 15	Percent of Occupied Beds: 100%
Total Number of Residents: 15	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: 07/17/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 2.51

Number of LPN/LVN Hours per Nursing Home Resident per Day: 1.15

Number of CNA Hours per Nursing Home Resident per Day: 2.46

Number of Staff Hours per Nursing Home Resident per Day: 6.12

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 28%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 71%
Percent of Short-Stay Residents With Delirium: 10%
** Details Last Reported on: 7/17/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-07-03	2001-08-16	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Widespread	Minimal harm or potential for actual harm
2001-07-03	2001-08-16	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
2001-07-03	2001-08-16	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
2002-06-13	2002-07-15	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
2003-07-17	2003-08-12	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	Minimal harm or potential for actual harm
2003-07-17	2003-08-12	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
2003-07-17	2003-08-12	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2003-07-17	2003-08-12	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2003-07-17	2003-08-12	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Isolated	Minimal harm or potential for actual harm
2003-07-17	2003-08-12	Pharmacy Service Deficiencies	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
2003-07-17	2003-08-12	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
2003-07-17	2003-08-12	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Isolated	Minimal harm or potential for actual harm
2003-07-17	2003-08-12	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm

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