Surrey Place St Lukes Hospital Skilled Nursing and Retirement Care Facility

Total Number of Beds: 44	Percent of Occupied Beds: 91%
Total Number of Residents: 40	Located Within a Hospital: Yes
Type of Ownership: Non profit - Church related	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 09/26/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 1.6

Number of LPN/LVN Hours per Nursing Home Resident per Day: 1.64

Number of CNA Hours per Nursing Home Resident per Day: 2.71

Number of Staff Hours per Nursing Home Resident per Day: 5.95

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 17%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 50%
Percent of Short-Stay Residents With Delirium: 1%
** Details Last Reported on: 9/26/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-08-29	2002-11-02	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Pattern	Potential for minimal harm

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