Fairfield Good Samaritan Center

Total Number of Beds: 51	Percent of Occupied Beds: 80%
Total Number of Residents: 41	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: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 04/03/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.89

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.49

Number of CNA Hours per Nursing Home Resident per Day: 1.96

Number of Staff Hours per Nursing Home Resident per Day: 3.34

Nursing Home Resident Information**:

Percent of Residents Who Have Moderate to Severe Pain: 5%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 0%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 17%
Percent of Residents Who are More Depressed or Anxious: 38%
Percent of Residents Who Were Physically Restrained: 3%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 24%
Percent of Residents With a Urinary Tract Infection: 10%
** Details Last Reported on: 4/3/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-07-27	2001-09-18	Resident Rights Deficiencies	Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged.	Isolated	Minimal harm or potential for actual harm
2001-07-27	2001-09-18	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Isolated	Minimal harm or potential for actual harm
2001-07-27	2001-09-18	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2001-07-27	2002-09-18	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
2001-07-27	2001-09-18	Quality Care Deficiencies	Make sure that each resident who enters the nursing home without a catheter is not given a catheter, unless it is necessary.	Isolated	Minimal harm or potential for actual harm
2001-07-27	2001-09-18	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	Minimal harm or potential for actual harm
2002-06-21	2002-08-05	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Potential for minimal harm
2002-06-21	2002-08-05	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2002-06-21	2002-08-05	Quality Care Deficiencies	Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.	Isolated	Minimal harm or potential for actual harm
2002-06-21	2002-08-05	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
2002-06-21	2002-08-05	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
2002-06-21	2002-08-05	Quality Care Deficiencies	Give or get special rehabilitation if in the patient's plan of care.	Isolated	Minimal harm or potential for actual harm
2003-04-03	2003-05-21	Resident Rights Deficiencies	Let the resident refuse treatment or refuse to take part in an experiment.	Isolated	Actual harm
2003-04-03	2003-05-21	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2003-04-03	2003-05-21	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
2003-04-03	2003-05-21	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2003-04-03	2003-05-21	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Actual harm
2003-04-03	2003-05-21	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
2003-04-03	2003-05-21	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
2003-04-03	2003-05-21	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
2003-04-03	2003-05-21	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2003-04-03	2003-05-21	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm

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