Fairfield Memorial Hosital

Total Number of Beds: 30	Percent of Occupied Beds: 70%
Total Number of Residents: 21	Located Within a Hospital: No
Type of Ownership: Non profit - Other	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 11/26/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 1.75

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.55

Number of CNA Hours per Nursing Home Resident per Day: 2.57

Number of Staff Hours per Nursing Home Resident per Day: 4.87

Nursing Home Resident Information**:

Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 35%
Percent of Short-Stay Residents With Delirium: 0%
** Details Last Reported on: 11/26/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-09-20	2001-11-13	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2001-09-20	2001-11-13	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Isolated	Minimal harm or potential for actual harm
2002-10-30	2002-11-12	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
2002-10-30	2002-12-13	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

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