Lake Region Hospital Skilled Nursing Facility

Total Number of Beds: 13	Percent of Occupied Beds: 85%
Total Number of Residents: 11	Located Within a Hospital: Yes
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 07/07/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 3.01

Number of LPN/LVN Hours per Nursing Home Resident per Day: 1.66

Number of CNA Hours per Nursing Home Resident per Day: 2.81

Number of Staff Hours per Nursing Home Resident per Day: 7.48

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 20%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 55%
Percent of Short-Stay Residents With Delirium: 0%
** Details Last Reported on: 7/7/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2003-07-07	2003-08-15	Resident Rights Deficiencies	Tell the resident completely about his or her health status.	Isolated	Minimal harm or potential for actual harm
2003-07-07	2003-08-15	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
2003-07-07	2003-08-15	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
2003-07-07	2003-08-15	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Widespread	Potential for minimal harm
2003-07-07	2003-08-15	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Pattern	Minimal harm or potential for actual harm
2003-07-07	2003-08-15	Resident Assessment Deficiencies	Assess the resident when the resident enters the nursing home, in a timely manner.	Isolated	Minimal harm or potential for actual harm
2003-07-07	2003-08-15	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Pattern	Minimal harm or potential for actual harm
2003-07-07	2003-08-15	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2003-07-07	2003-08-15	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2003-07-07	2003-08-15	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Pattern	Minimal harm or potential for actual harm
2003-07-07	2003-08-15	Quality Care Deficiencies	Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	Isolated	Minimal harm or potential for actual harm
2003-07-07	2003-08-15	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
2003-07-07	2003-07-07	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
2003-07-07	2003-08-15	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Widespread	Potential for minimal harm
2003-07-07	2003-08-15	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Isolated	Minimal harm or potential for actual harm
2003-07-07	2003-08-15	Environmental Deficiencies	Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection.	Isolated	Minimal harm or potential for actual harm
2003-07-07	2003-07-07	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Potential for minimal harm
2003-07-07	2003-08-15	Administration Deficiencies	Give or get lab tests to meet the needs of residents.	Isolated	Minimal harm or potential for actual harm

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