Hickory Creek at Columbus

Total Number of Beds: 38	Percent of Occupied Beds: 82%
Total Number of Residents: 31	Located Within a Hospital: No
Type of Ownership: Non profit - Corporation	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: 05/30/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.45

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.59

Number of CNA Hours per Nursing Home Resident per Day: 1.29

Number of Staff Hours per Nursing Home Resident per Day: 2.33

Nursing Home Resident Information**:

Percent of Residents Who Have Moderate to Severe Pain: 5%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 6%
Percent of Residents Who Were Physically Restrained: 0%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 7%
Percent of Residents With a Urinary Tract Infection: 0%
** Details Last Reported on: 5/30/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-03-16	2001-04-10	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
2001-03-16	2001-04-10	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2001-03-16	2001-04-10	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2001-03-16	2001-04-10	Quality Care Deficiencies	Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.	Pattern	Minimal harm or potential for actual harm
2001-03-16	2001-04-10	Quality Care Deficiencies	Use a registered nurse at least 8 hours a day, 7 days a week.	Pattern	Minimal harm or potential for actual harm
2001-03-16	0000-00-00	Environmental Deficiencies	Provide rooms that are big enough for each resident.	Pattern	Potential for minimal harm
2002-04-24	2002-06-14	Resident Rights Deficiencies	Try to resolve each resident's complaints quickly.	Isolated	Minimal harm or potential for actual harm
2002-04-24	2002-06-14	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
2002-04-24	2002-06-14	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Isolated	Minimal harm or potential for actual harm
2002-04-24	2002-06-14	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2002-04-24	2002-06-14	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
2002-04-24	2002-06-14	Environmental Deficiencies	Provide rooms that are big enough for each resident.	Pattern	Potential for minimal harm
2002-04-24	2002-06-14	Administration Deficiencies	Make sure that nurse aides show they have the skills to be able to care for residents.	Isolated	Minimal harm or potential for actual harm
2002-04-24	2002-06-14	Administration Deficiencies	Give or get lab tests by a certified laboratory.	Pattern	Minimal harm or potential for actual harm
2002-04-24	2002-06-14	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
2003-05-30	2003-08-15	Environmental Deficiencies	Provide rooms that are big enough for each resident.	Isolated	Minimal harm or potential for actual harm

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