St Mary Medical Center Skilled Nursing Facility

Total Number of Beds: 14	Percent of Occupied Beds: 36%
Total Number of Residents: 5	Located Within a Hospital: Yes
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: 01/10/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 6.28

Number of LPN/LVN Hours per Nursing Home Resident per Day: 4.28

Number of CNA Hours per Nursing Home Resident per Day: 4

Number of Staff Hours per Nursing Home Resident per Day: 14.56

Nursing Home Resident Information**:

** Details Last Reported on: 1/10/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2000-11-09	2001-01-05	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
2000-11-09	2000-11-09	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
2000-11-09	2000-11-29	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2000-11-09	2001-02-07	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2000-11-09	2001-01-05	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
2000-11-09	2001-01-05	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
2000-11-09	2001-01-05	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2000-11-09	2001-01-05	Environmental Deficiencies	Keep a resident apart from the others if the resident has an infection that can spread.	Isolated	Minimal harm or potential for actual harm
2000-11-09	2000-11-09	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.	Isolated	Minimal harm or potential for actual harm
2001-12-04	2002-01-18	Mistreatment Deficiencies	1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents.	Widespread	Potential for minimal harm
2001-12-04	2002-01-28	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Isolated	Minimal harm or potential for actual harm
2001-12-04	2002-01-28	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
2001-12-04	2002-01-28	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2001-12-04	2002-01-28	Administration Deficiencies	Set up or keep a group of people to review and ensure quality.	Isolated	Minimal harm or potential for actual harm
2003-01-10	0000-00-00	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm

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