Sampson Regional Medical Center

Total Number of Beds: 30	Percent of Occupied Beds: 90%
Total Number of Residents: 27	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 and Medicaid
* Details Last Reported on: 08/05/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 2.37

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.71

Number of CNA Hours per Nursing Home Resident per Day: 2.84

Number of Staff Hours per Nursing Home Resident per Day: 5.92

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 18%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 14%
Percent of Short-Stay Residents With Delirium: 4%
** Details Last Reported on: 8/5/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-11-20	2002-01-02	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
2001-11-20	2002-01-02	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Pattern	Minimal harm or potential for actual harm
2001-11-20	2001-11-20	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2002-10-30	2002-11-21	Mistreatment Deficiencies	1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents.	Isolated	Minimal harm or potential for actual harm
2002-10-30	2002-11-21	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2002-10-30	2002-11-21	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
2002-10-30	2002-11-21	Pharmacy Service Deficiencies	Make sure that the pharmacist reports anything unusual to the doctor on duty and the director of nursing.	Isolated	Minimal harm or potential for actual harm
2003-08-05	2003-08-22	Pharmacy Service Deficiencies	1) Make sure that residents who take drugs are not given too many doses or for too long; 2) make sure that the use of drugs is carefully watched; or 3) stop or change drugs that cause unwanted effects.	Isolated	Minimal harm or potential for actual harm
2003-08-05	2003-08-22	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.