Crosby Good Samaritan Center

Total Number of Beds: 67	Percent of Occupied Beds: 85%
Total Number of Residents: 57	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: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 05/15/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.77

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.35

Number of CNA Hours per Nursing Home Resident per Day: 2.32

Number of Staff Hours per Nursing Home Resident per Day: 3.44

Nursing Home Resident Information**:

Percent of High-Risk Residents Who Have Pressure Sores: 7%
Percent of Residents Who Have Moderate to Severe Pain: 5%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 17%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 0%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 29%
Percent of Residents Who are More Depressed or Anxious: 24%
Percent of Residents Who Were Physically Restrained: 0%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 51%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 4%
Percent of Residents With a Urinary Tract Infection: 0%
** Details Last Reported on: 5/15/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-07-19	2001-09-17	Resident Assessment Deficiencies	1) Develop a complete care plan within 7 days of each resident's admission; 2) prepare a care plan with the care team, including the primary nurse, doctor, resident or resident's family or representative; or 3) check and update the care plan.	Pattern	Potential for minimal harm
2001-07-19	2001-09-17	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Pattern	Minimal harm or potential for actual harm
2001-07-19	2001-09-17	Quality Care Deficiencies	Give each resident enough fluids to keep them healthy and prevent dehydration.	Pattern	Minimal harm or potential for actual harm
2001-07-19	2001-07-26	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
2001-07-19	2001-07-20	Environmental Deficiencies	Be designed, built, equipped, or well kept to protect the health and safety of residents, workers, and the public.	Pattern	Minimal harm or potential for actual harm
2002-06-05	2002-07-20	Resident Assessment Deficiencies	Keep assessments completed in the preceding 15 months in the resident's active record.	Pattern	Potential for minimal harm
2003-05-15	2003-06-19	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Isolated	Minimal harm or potential for actual harm
2003-05-15	2003-06-19	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2003-05-15	2003-06-19	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2003-05-15	2003-06-19	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2003-05-15	2003-06-19	Administration Deficiencies	Hire nurse aides who have completed required training and shown that they are skilled.	Pattern	Potential for minimal harm

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