| Total Number of Beds: 114 | Percent of Occupied Beds: 89% |
| Total Number of Residents: 102 | 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: 08/20/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-08-30 |
2001-09-27 |
Resident Rights Deficiencies |
Provide services to meet the needs and preferences of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-08-30 |
2001-09-27 |
Quality Care Deficiencies |
Give professional services that meet a professional standard of quality. |
Pattern |
Minimal harm or potential for actual harm |
| 2001-08-30 |
2001-09-27 |
Quality Care Deficiencies |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Isolated |
Actual harm |
| 2001-08-30 |
2001-09-27 |
Quality Care Deficiencies |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Actual harm |
| 2001-08-30 |
2001-09-27 |
Quality Care Deficiencies |
Give each resident enough fluids to keep them healthy and prevent dehydration. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-08-30 |
2001-09-27 |
Nutrition and Dietary Deficiencies |
Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. |
Pattern |
Potential for minimal harm |
| 2002-09-17 |
2002-09-18 |
Quality Care Deficiencies |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-09-17 |
2002-09-18 |
Quality Care Deficiencies |
Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-09-17 |
2002-09-18 |
Nutrition and Dietary Deficiencies |
1) Provide 3 meals daily at regular times; or 2) serve breakfast within 14 hours after dinner; or 3) offer a snack at bedtime each day. |
Pattern |
Potential for minimal harm |
| 2003-08-20 |
2003-08-20 |
Resident Rights Deficiencies |
Tell each resident who can get Medicaid benefits about 1) which items and services Medicaid covers and which the resident must pay for; or 2) how to apply for Medicaid, along with the names and addresses of State groups that can help. |
Widespread |
Potential for minimal harm |
*** All violations listed are based on federal government records.