Hickory Creek at Crawfordsvill

Total Number of Beds: 36	Percent of Occupied Beds: 72%
Total Number of Residents: 26	Located Within a Hospital: No
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 05/07/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.57

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.75

Number of CNA Hours per Nursing Home Resident per Day: 1.42

Number of Staff Hours per Nursing Home Resident per Day: 2.74

Nursing Home Resident Information**:

** Details Last Reported on: 5/7/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-05-02	2001-06-01	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2001-05-02	2001-06-01	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Minimal harm or potential for actual harm
2001-05-02	2001-06-01	Quality Care Deficiencies	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Isolated	Actual harm
2001-05-02	2001-06-05	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Pattern	Minimal harm or potential for actual harm
2001-05-02	2001-06-01	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2001-05-02	2001-06-07	Resident Assessment Deficiencies	Develop a plan with the resident and family for the resident's care after leaving the nursing home.	Isolated	Minimal harm or potential for actual harm
2001-05-02	2001-06-01	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2001-05-02	2001-06-01	Quality Care Deficiencies	Give each resident enough fluids to keep them healthy and prevent dehydration.	Pattern	Minimal harm or potential for actual harm
2001-05-02	0000-00-00	Environmental Deficiencies	Provide rooms that are big enough for each resident.	Pattern	Potential for minimal harm
2002-07-16	2002-08-08	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
2002-07-16	2002-08-06	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2002-07-16	2002-08-08	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
2002-07-16	2002-08-08	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Actual harm
2002-07-16	2002-07-17	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
2002-07-16	0000-00-00	Environmental Deficiencies	Provide rooms that are big enough for each resident.	Pattern	Potential for minimal harm
2002-07-16	2002-08-07	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Minimal harm or potential for actual harm
2003-05-07	2003-06-06	Quality Care Deficiencies	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Isolated	Actual harm
2003-05-07	2003-06-06	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
2003-05-07	2003-05-31	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Potential for minimal harm
2003-05-07	2003-06-06	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm

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