| Total Number of Beds: 100 | Percent of Occupied Beds: 95% |
| Total Number of Residents: 95 | Located Within a Hospital: No |
| Type of Ownership: For profit - Corporation | Multiple Nursing Homes by Same Owner: No |
| Councils the Nursing Home Participates in: Family & Resident | Medicare/Medicaid: Participating in Medicare and Medicaid |
| * Details Last Reported on: 03/20/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2002-05-23 |
2002-07-22 |
Resident Rights Deficiencies |
Keep each resident's personal and medical records private and confidential. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-05-23 |
2002-07-03 |
Mistreatment Deficiencies |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-05-23 |
2002-07-03 |
Resident Rights Deficiencies |
Provide services to meet the needs and preferences of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-05-23 |
2002-07-22 |
Environmental Deficiencies |
Keep safe, clean and homelike surroundings. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-05-23 |
2002-07-03 |
Environmental Deficiencies |
Provide needed housekeeping and maintenance. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-05-23 |
2002-07-03 |
Resident Assessment Deficiencies |
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-05-23 |
2002-06-12 |
Quality Care Deficiencies |
Give professional services that meet a professional standard of quality. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-05-23 |
2002-07-03 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-05-23 |
2002-07-22 |
Environmental Deficiencies |
Provide bedrooms that don't allow residents to see each other when privacy is needed. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-05-23 |
2002-07-22 |
Administration Deficiencies |
Train all employees on what to do in an emergency. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-03-20 |
2003-03-21 |
Environmental Deficiencies |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-03-20 |
2003-04-30 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Pattern |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.