| Total Number of Beds: 100 | Percent of Occupied Beds: 85% |
| Total Number of Residents: 85 | Located Within a Hospital: No |
| Type of Ownership: Government - State | Multiple Nursing Homes by Same Owner: No |
| Councils the Nursing Home Participates in: Resident | Medicare/Medicaid: Participating in Medicare and Medicaid |
| * Details Last Reported on: 10/16/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-07-18 |
2001-08-07 |
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 |
| 2001-07-18 |
2001-08-13 |
Resident Rights Deficiencies |
Keep each resident's personal and medical records private and confidential. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-07-18 |
2001-08-13 |
Environmental Deficiencies |
Provide needed housekeeping and maintenance. |
Widespread |
Potential for minimal harm |
| 2001-07-18 |
2001-08-07 |
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 |
| 2001-07-18 |
2001-08-07 |
Resident Assessment Deficiencies |
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-07-18 |
2001-08-07 |
Environmental Deficiencies |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-07-18 |
2001-08-07 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Pattern |
Minimal harm or potential for actual harm |
| 2001-07-18 |
2001-08-12 |
Administration Deficiencies |
1) Set up a group that is legally responsible for writing and setting up policies for leading and running the nursing home; or 2) hire a properly licensed administrator. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-10-16 |
2003-11-03 |
Quality Care Deficiencies |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-10-16 |
2003-11-03 |
Pharmacy Service Deficiencies |
Make sure that residents are safe from serious medication errors. |
Isolated |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.