St. Helena Hospital Skilled Nursing Facility

Total Number of Beds: 23	Percent of Occupied Beds: 48%
Total Number of Residents: 11	Located Within a Hospital: Yes
Type of Ownership: Non profit - Church related	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Family	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 01/28/2003

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 With Pressure Sores: 29%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 48%
Percent of Short-Stay Residents With Delirium: 10%
** Details Last Reported on: 1/28/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2000-11-22	2001-01-30	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Pattern	Potential for minimal harm
2000-11-22	2001-01-30	Resident Rights Deficiencies	Let residents give themselves their drugs if they are able.	Isolated	Minimal harm or potential for actual harm
2000-11-22	2001-01-30	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Minimal harm or potential for actual harm
2000-11-22	2001-01-30	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
2000-11-22	2001-01-30	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
2000-11-22	2001-01-30	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.	Isolated	Minimal harm or potential for actual harm
2000-11-22	2001-01-30	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2000-11-22	2001-01-30	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Pattern	Minimal harm or potential for actual harm
2000-11-22	2001-01-30	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
2000-11-22	2001-01-30	Pharmacy Service Deficiencies	Make sure that the pharmacist reports anything unusual to the doctor on duty and the director of nursing.	Isolated	Minimal harm or potential for actual harm
2000-11-22	2001-01-30	Administration Deficiencies	Choose a doctor to be the medical director.	Isolated	Minimal harm or potential for actual harm
2000-11-22	2001-01-30	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
2000-11-22	2001-01-30	Administration Deficiencies	Train all employees on what to do in an emergency.	Isolated	Minimal harm or potential for actual harm
2001-12-19	2002-01-31	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Isolated	Minimal harm or potential for actual harm
2001-12-19	2002-01-31	Resident Assessment Deficiencies	Assess the resident when the resident enters the nursing home, in a timely manner.	Isolated	Minimal harm or potential for actual harm
2001-12-19	2002-01-31	Administration Deficiencies	Train all employees on what to do in an emergency.	Isolated	Minimal harm or potential for actual harm
2003-01-28	2003-02-20	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Pattern	Potential for minimal harm
2003-01-28	2003-02-20	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2003-01-28	2003-02-20	Environmental Deficiencies	Keep all essential equipment working safely.	Isolated	Minimal harm or potential for actual harm

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