Forum at Deer Creek, the

Total Number of Beds: 60	Percent of Occupied Beds: 87%
Total Number of Residents: 52	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 and Medicaid
* Details Last Reported on: 09/11/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.33

Number of LPN/LVN Hours per Nursing Home Resident per Day: 1.04

Number of CNA Hours per Nursing Home Resident per Day: 2.9

Number of Staff Hours per Nursing Home Resident per Day: 4.27

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 21%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 20%
Percent of Residents Who Have Moderate to Severe Pain: 4%
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: 20%
Percent of Residents Who are More Depressed or Anxious: 20%
Percent of Short-Stay Residents With Delirium: 0%
Percent of Residents Who Were Physically Restrained: 13%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 3%
Percent of Residents With a Urinary Tract Infection: 8%
** Details Last Reported on: 9/11/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-11-07	2001-12-12	Resident Rights Deficiencies	Try to resolve each resident's complaints quickly.	Widespread	Potential for minimal harm
2001-11-07	2001-12-12	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
2001-11-07	2001-12-12	Resident Assessment Deficiencies	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Isolated	Minimal harm or potential for actual harm
2001-11-07	2001-12-12	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
2001-11-07	2001-12-12	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Minimal harm or potential for actual harm
2002-10-04	2002-11-19	Resident Rights Deficiencies	Let residents give themselves their drugs if they are able.	Isolated	Minimal harm or potential for actual harm
2002-10-04	2002-11-19	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Isolated	Minimal harm or potential for actual harm
2002-10-04	2002-11-19	Administration Deficiencies	Quickly tell the resident's doctor the results of lab tests.	Isolated	Minimal harm or potential for actual harm
2003-09-11	2003-10-23	Resident Rights Deficiencies	Try to resolve each resident's complaints quickly.	Isolated	Minimal harm or potential for actual harm
2003-09-11	2003-10-23	Resident Assessment Deficiencies	Check and update (if needed) each resident's assessment every 3 months.	Isolated	Minimal harm or potential for actual harm
2003-09-11	2003-10-23	Resident Assessment Deficiencies	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Isolated	Minimal harm or potential for actual harm
2003-09-11	2003-10-23	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
2003-09-11	2003-10-23	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
2003-09-11	2003-10-23	Nutrition and Dietary Deficiencies	Provide food in a way that meets a resident's needs.	Isolated	Minimal harm or potential for actual harm
2003-09-11	2003-10-23	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm

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