Hampshire Manor Nursing Home

Total Number of Beds: 42	Percent of Occupied Beds: 88%
Total Number of Residents: 37	Located Within a Hospital: No
Type of Ownership: For profit - Individual	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 08/17/2000

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.72

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.28

Number of CNA Hours per Nursing Home Resident per Day: 1.95

Number of Staff Hours per Nursing Home Resident per Day: 2.95

Nursing Home Resident Information**:

** Details Last Reported on: 8/17/2000

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
1998-08-18	1998-11-20	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Actual harm
1998-08-18	1998-11-20	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.	Isolated	Actual harm
1998-08-18	1998-11-20	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
1998-08-18	1998-11-20	Environmental Deficiencies	Have enough backup water supply for important areas of the nursing home.	Widespread	Potential for minimal harm
1998-08-18	1998-11-20	Environmental Deficiencies	Make sure there is a program to prevent/deal with mice, insects, or other pests.	Widespread	Potential for minimal harm
1999-06-04	1999-08-31	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
1999-06-04	1999-08-31	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Pattern	Potential for minimal harm
1999-06-04	1999-11-03	Mistreatment Deficiencies	1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents.	Isolated	Minimal harm or potential for actual harm
1999-06-04	1999-11-02	Quality Care Deficiencies	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Isolated	Minimal harm or potential for actual harm
1999-06-04	2000-01-10	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Widespread	Potential for minimal harm
1999-06-04	1999-08-31	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
1999-06-04	1999-08-31	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Minimal harm or potential for actual harm
1999-06-04	1999-08-31	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
1999-06-04	1999-11-03	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Actual harm
1999-06-04	1999-08-31	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Actual harm
1999-06-04	1999-08-31	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Widespread	Potential for minimal harm
1999-06-04	1999-08-31	Nutrition and Dietary Deficiencies	Provide special eating equipment and utensils for each resident who needs them.	Isolated	Minimal harm or potential for actual harm
1999-06-04	1999-08-31	Environmental Deficiencies	Get rid of garbage properly.	Pattern	Minimal harm or potential for actual harm
1999-06-04	1999-08-31	Resident Assessment Deficiencies	Make sure that doctors visit residents regularly, as required.	Isolated	Minimal harm or potential for actual harm
1999-06-04	1999-11-02	Environmental Deficiencies	Make sure there is a program to prevent/deal with mice, insects, or other pests.	Pattern	Minimal harm or potential for actual harm
1999-06-04	1999-11-02	Administration Deficiencies	Train all employees on what to do in an emergency.	Widespread	Minimal harm or potential for actual harm
1999-06-04	1999-11-02	Administration Deficiencies	Set up or keep a group of people to review and ensure quality.	Widespread	Minimal harm or potential for actual harm
2000-08-17	2000-11-30	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
2000-08-17	2000-11-30	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Widespread	Potential for minimal harm
2000-08-17	2000-11-30	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
2000-08-17	2000-11-30	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
2000-08-17	2000-11-30	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2000-08-17	2000-11-30	Quality Care Deficiencies	Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.	Pattern	Minimal harm or potential for actual harm
2000-08-17	2000-11-30	Quality Care Deficiencies	Make sure that each resident gets help to keep vision and hearing.	Isolated	Minimal harm or potential for actual harm
2000-08-17	2000-11-30	Pharmacy Service Deficiencies	1) Make sure that residents who take drugs are not given too many doses or for too long; 2) make sure that the use of drugs is carefully watched; or 3) stop or change drugs that cause unwanted effects.	Isolated	Minimal harm or potential for actual harm
2000-08-17	2000-11-30	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
2000-08-17	2000-11-30	Pharmacy Service Deficiencies	Act when the pharmacist reports something unusual.	Isolated	Minimal harm or potential for actual harm
2000-08-17	2000-11-30	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
2000-08-17	2000-11-30	Environmental Deficiencies	Provide enough emergency electricity.	Isolated	Minimal harm or potential for actual harm
2000-08-17	2000-11-30	Environmental Deficiencies	Make sure there is a program to prevent/deal with mice, insects, or other pests.	Widespread	Minimal harm or potential for actual harm
2000-08-17	2000-11-30	Administration Deficiencies	Get proof that a nurse aide has the training and skills that the State requires.	Isolated	Minimal harm or potential for actual harm
2000-08-17	2000-11-30	Administration Deficiencies	Set up or keep a group of people to review and ensure quality.	Widespread	Minimal harm or potential for actual harm

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