| Total Number of Beds: 122 | Percent of Occupied Beds: 98% |
| Total Number of Residents: 120 | 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: Family & Resident | Medicare/Medicaid: Participating in Medicare and Medicaid |
| * Details Last Reported on: 10/22/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-07-26 |
2001-12-31 |
Pharmacy Service Deficiencies |
Make sure that residents are safe from serious medication errors. |
Pattern |
Potential for minimal harm |
| 2002-09-13 |
0000-00-00 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-09-13 |
0000-00-00 |
Environmental Deficiencies |
Provide at least one room to use as a dining room and for activities, that is a good size, with good lighting, airflow and furniture. |
Pattern |
Potential for minimal harm |
| 2003-10-22 |
2004-01-22 |
Resident Rights Deficiencies |
Let the resident refuse treatment or refuse to take part in an experiment. |
Pattern |
Minimal harm or potential for actual harm |
| 2003-10-22 |
2003-11-28 |
Resident Rights Deficiencies |
Quickly give a resident's personal money to the heads of his or her estate after the resident's death. |
Pattern |
Potential for minimal harm |
| 2003-10-22 |
2004-01-15 |
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. |
Pattern |
Minimal harm or potential for actual harm |
| 2003-10-22 |
2003-12-01 |
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 |
Minimal harm or potential for actual harm |
| 2003-10-22 |
2004-01-15 |
Environmental Deficiencies |
Provide rooms that are big enough for each resident. |
Pattern |
Potential for minimal harm |
*** All violations listed are based on federal government records.