| Total Number of Beds: 113 | Percent of Occupied Beds: 96% |
| Total Number of Residents: 108 | Located Within a Hospital: No |
| Type of Ownership: Non profit - Church related | Multiple Nursing Homes by Same Owner: No |
| Councils the Nursing Home Participates in: Family & Resident | Medicare/Medicaid: Participating in Medicare and Medicaid |
| * Details Last Reported on: 05/08/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-06-07 |
2001-07-22 |
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 |
| 2001-06-07 |
2001-07-14 |
Environmental Deficiencies |
Have enough outside airflow. |
Widespread |
Potential for minimal harm |
| 2002-05-16 |
2002-06-24 |
Resident Rights Deficiencies |
Give the resident's legal representative the same rights as the resident. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-05-16 |
2002-06-25 |
Resident Rights Deficiencies |
Provide services to meet the needs and preferences of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-05-16 |
2002-05-31 |
Resident Assessment Deficiencies |
1) Develop a complete care plan within 7 days of each resident's admission; 2) prepare a care plan with the care team, including the primary nurse, doctor, resident or resident's family or representative; or 3) check and update the care plan. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-05-08 |
2003-06-11 |
Mistreatment Deficiencies |
Protect residents from mistreatment, neglect, and/or theft of personal property. |
Pattern |
Minimal harm or potential for actual harm |
| 2003-05-08 |
2003-06-11 |
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 |
| 2003-05-08 |
2003-06-11 |
Resident Assessment Deficiencies |
Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them. |
Pattern |
Minimal harm or potential for actual harm |
| 2003-05-08 |
2003-06-11 |
Quality Care Deficiencies |
Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-05-08 |
2003-06-11 |
Environmental Deficiencies |
Make sure that the nursing home area is free of dangers that cause accidents. |
Pattern |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.