Autumn Leaves Nursing Center

Total Number of Beds: 30	Percent of Occupied Beds: 33%
Total Number of Residents: 10	Located Within a Hospital: No
Type of Ownership: For profit - Partnership	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 04/26/2003

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 Who Had Moderate to Severe Pain: 4%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 3%
Percent of Short-Stay Residents With Delirium: 14%
Percent of Residents Who Were Physically Restrained: 6%
Percent of Residents With a Urinary Tract Infection: 13%
** Details Last Reported on: 4/26/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-05-10	2001-06-24	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
2001-05-10	2001-06-24	Quality Care Deficiencies	Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	Isolated	Minimal harm or potential for actual harm
2001-05-10	2001-06-24	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2001-05-10	2001-06-24	Environmental Deficiencies	Get rid of garbage properly.	Widespread	Potential for minimal harm
2001-05-10	2001-06-24	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Pattern	Potential for minimal harm
2001-05-10	2001-06-24	Environmental Deficiencies	Make sure that a working call system is available in each resident's room or bathroom and bathing area.	Widespread	Potential for minimal harm
2002-05-24	2002-08-05	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
2002-05-24	2002-07-08	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
2002-05-24	2002-07-17	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2002-05-24	2002-07-08	Environmental Deficiencies	Get rid of garbage properly.	Widespread	Potential for minimal harm
2002-05-24	2002-08-05	Environmental Deficiencies	Make sure there is a program to prevent/deal with mice, insects, or other pests.	Widespread	Potential for minimal harm
2003-04-26	2003-05-26	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
2003-04-26	2003-05-26	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Pattern	Immediate jeopardy to resident health or safety
2003-04-26	2003-05-04	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
2003-04-26	2003-05-04	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Immediate jeopardy to resident health or safety
2003-04-26	2003-05-04	Pharmacy Service Deficiencies	Make sure that residents are safe from serious medication errors.	Pattern	Immediate jeopardy to resident health or safety
2003-04-26	2003-05-26	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
2003-04-26	2003-05-04	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Pattern	Immediate jeopardy to resident health or safety
2003-04-26	2003-05-04	Pharmacy Service Deficiencies	Use the services of a licensed pharmacist.	Pattern	Immediate jeopardy to resident health or safety
2003-04-26	2003-05-04	Administration Deficiencies	Be administered in a way that leads to the highest possible level of well being for each resident.	Pattern	Immediate jeopardy to resident health or safety

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