Jacobson Memorial Hospital Center

Total Number of Beds: 25	Percent of Occupied Beds: 100%
Total Number of Residents: 25	Located Within a Hospital: Yes
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 12/03/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.76

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.73

Number of CNA Hours per Nursing Home Resident per Day: 2.7

Number of Staff Hours per Nursing Home Resident per Day: 4.19

Nursing Home Resident Information**:

** Details Last Reported on: 12/3/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-03-13	2002-04-30	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Pattern	Potential for minimal harm
2002-03-13	2002-04-30	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Widespread	Potential for minimal harm
2002-03-13	2002-04-30	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2003-01-16	2003-03-04	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
2003-01-16	2003-03-04	Resident Rights Deficiencies	Quickly give a resident's personal money to the heads of his or her estate after the resident's death.	Isolated	Minimal harm or potential for actual harm
2003-01-16	2003-03-04	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Pattern	Minimal harm or potential for actual harm
2003-01-16	2003-03-04	Resident Rights Deficiencies	Provide enough notice before discharging or transferring a resident.	Isolated	Minimal harm or potential for actual harm
2003-01-16	2003-03-04	Resident Rights Deficiencies	Tell the resident or the resident's representative in writing how long the nursing home will hold the resident's bed when the resident temporarily leaves the facility.	Isolated	Minimal harm or potential for actual harm
2003-01-16	2003-03-04	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2003-01-16	2003-03-04	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
2003-01-16	2003-03-04	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2003-01-16	2003-03-04	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Isolated	Minimal harm or potential for actual harm
2003-01-16	2003-03-04	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Isolated	Minimal harm or potential for actual harm
2003-01-16	2003-03-04	Environmental Deficiencies	Provide bedrooms that don't allow residents to see each other when privacy is needed.	Isolated	Minimal harm or potential for actual harm
2003-01-16	2003-03-04	Administration Deficiencies	Follow all laws and professional standards.	Widespread	Minimal harm or potential for actual harm
2003-01-16	2003-03-04	Administration Deficiencies	Hire nurse aides who have completed required training and shown that they are skilled.	Pattern	Potential for minimal harm
2003-12-03	2004-01-07	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2003-12-03	2004-01-07	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

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