Adams County Memorial Hospital

Total Number of Beds: 22	Percent of Occupied Beds: 55%
Total Number of Residents: 12	Located Within a Hospital: Yes
Type of Ownership: Government - County	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 09/05/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 3.62

Number of LPN/LVN Hours per Nursing Home Resident per Day: 2.72

Number of CNA Hours per Nursing Home Resident per Day: 4.9

Number of Staff Hours per Nursing Home Resident per Day: 11.24

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 30%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 30%
Percent of Short-Stay Residents With Delirium: 16%
** Details Last Reported on: 9/5/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-09-07	2001-10-05	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Minimal harm or potential for actual harm
2001-09-07	2001-09-21	Administration Deficiencies	Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person.	Pattern	Potential for minimal harm
2003-09-05	2003-10-03	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

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