Health Care Center at The Forum

Total Number of Beds: 45	Percent of Occupied Beds: 69%
Total Number of Residents: 31	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 09/18/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.64

Number of LPN/LVN Hours per Nursing Home Resident per Day: 1.03

Number of CNA Hours per Nursing Home Resident per Day: 2.59

Number of Staff Hours per Nursing Home Resident per Day: 4.26

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 32%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 23%
Percent of Short-Stay Residents With Delirium: 1%
** Details Last Reported on: 9/18/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-11-15	2003-01-08	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.	Pattern	Potential for minimal harm
2002-11-15	2003-01-08	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
2002-11-15	2003-01-08	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2002-11-15	2003-01-08	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
2003-09-18	2003-11-11	Nutrition and Dietary Deficiencies	Provide a tasty and well-balanced diet that meets the nutritional needs of each resident.	Isolated	Minimal harm or potential for actual harm
2003-09-18	2003-11-11	Nutrition and Dietary Deficiencies	Provide food in a way that meets a resident's needs.	Isolated	Minimal harm or potential for actual harm
2003-09-18	2003-11-11	Administration Deficiencies	Train all employees on what to do in an emergency.	Widespread	Minimal harm or potential for actual harm

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