| Total Number of Beds: 119 | Percent of Occupied Beds: 73% |
| Total Number of Residents: 87 | Located Within a Hospital: No |
| Type of Ownership: Non profit - Church related | 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: 10/10/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2002-11-06 |
2002-12-14 |
Quality Care Deficiencies |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-11-06 |
2002-12-14 |
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 |
| 2002-11-06 |
0000-00-00 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Potential for minimal harm |
| 2003-10-10 |
2003-11-06 |
Resident Rights Deficiencies |
Keep each resident's personal and medical records private and confidential. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-10-10 |
2003-11-06 |
Environmental Deficiencies |
Provide needed housekeeping and maintenance. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-10-10 |
2003-11-06 |
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 |
| 2003-10-10 |
2003-11-06 |
Quality Care Deficiencies |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-10-10 |
2003-11-06 |
Quality Care Deficiencies |
Make sure that residents with loss of bladder control receive treatment or service to prevent infections and help get normal bladder control. |
Pattern |
Minimal harm or potential for actual harm |
| 2003-10-10 |
2003-11-06 |
Quality Care Deficiencies |
Prevent a loss in range of motion among residents who entered the nursing home with a full range of motion. |
Isolated |
Actual harm |
| 2003-10-10 |
2003-11-06 |
Environmental Deficiencies |
Make sure that staff members wash their hands when needed. |
Isolated |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.