| Total Number of Beds: 12 | Percent of Occupied Beds: 42% |
| Total Number of Residents: 5 | Located Within a Hospital: No |
| Type of Ownership: Non profit - Church related | Multiple Nursing Homes by Same Owner: Yes |
| Councils the Nursing Home Participates in: Resident | Medicare/Medicaid: Participating in Medicare Only |
| * Details Last Reported on: 03/28/2003 |
Nursing Home Staff Information:
| Number of RN Hours per Nursing Home Resident per Day: |
| Number of LPN/LVN Hours per Nursing Home Resident per Day: |
| Number of CNA Hours per Nursing Home Resident per Day: |
| Number of Staff Hours per Nursing Home Resident per Day: |
Nursing Home Resident Information**:
Percent of Short-Stay Residents With Pressure Sores: 25%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 23%
Percent of Short-Stay Residents With Delirium: 0%
** Details Last Reported on: 3/28/2003
Nursing Home Inspection Violations:
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2002-02-27 |
2002-03-28 |
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 |
| 2003-03-28 |
2003-04-25 |
Environmental Deficiencies |
Make sure that the nursing home area is free of dangers that cause accidents. |
Pattern |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.
