Pilgrim Manor

Total Number of Beds: 55	Percent of Occupied Beds: 93%
Total Number of Residents: 51	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: 05/01/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.26

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.94

Number of CNA Hours per Nursing Home Resident per Day: 2.43

Number of Staff Hours per Nursing Home Resident per Day: 3.63

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 15%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 13%
Percent of Residents Who Have Moderate to Severe Pain: 0%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 14%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 0%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 10%
Percent of Residents Who are More Depressed or Anxious: 7%
Percent of Short-Stay Residents With Delirium: 10%
Percent of Residents Who Were Physically Restrained: 26%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 39%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 2%
Percent of Residents With a Urinary Tract Infection: 2%
** Details Last Reported on: 5/1/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-08-03	2001-09-15	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
2001-08-03	2001-09-15	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
2001-08-03	2001-09-15	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
2001-08-03	2001-09-15	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
2001-08-03	2001-09-15	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Actual harm
2001-08-03	2001-09-15	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	Potential for minimal harm
2001-08-03	2001-09-15	Nutrition and Dietary Deficiencies	Provide special eating equipment and utensils for each resident who needs them.	Pattern	Potential for minimal harm
2001-08-03	2001-09-15	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2001-08-03	2001-09-15	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Isolated	Minimal harm or potential for actual harm
2001-08-03	2001-09-15	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
2001-08-03	2001-09-15	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Potential for minimal harm
2001-08-03	2001-09-15	Administration Deficiencies	Get proof that a nurse aide has the training and skills that the State requires.	Pattern	Potential for minimal harm
2002-07-12	2002-08-01	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
2002-07-12	2002-08-01	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Potential for minimal harm
2002-07-12	2002-08-01	Quality Care Deficiencies	Use a registered nurse at least 8 hours a day, 7 days a week.	Isolated	Minimal harm or potential for actual harm
2002-07-12	2002-08-01	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	Potential for minimal harm
2002-07-12	2002-08-01	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2002-07-12	2002-08-01	Resident Assessment Deficiencies	Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing.	Pattern	Potential for minimal harm
2002-07-12	2002-08-01	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Potential for minimal harm
2003-05-01	2003-06-25	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.	Isolated	Minimal harm or potential for actual harm
2003-05-01	2003-06-25	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Potential for minimal harm
2003-05-01	2003-06-25	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
2003-05-01	2003-06-25	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Actual harm
2003-05-01	2003-10-01	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Actual harm
2003-05-01	2003-06-25	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.	Pattern	Potential for minimal harm
2003-05-01	2003-08-22	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
2003-05-01	2003-06-25	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Isolated	Minimal harm or potential for actual harm
2003-05-01	2003-06-25	Environmental Deficiencies	Provide bedrooms that don't allow residents to see each other when privacy is needed.	Isolated	Minimal harm or potential for actual harm

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