Pine Lake Nursing Home

Total Number of Beds: 58	Percent of Occupied Beds: 81%
Total Number of Residents: 47	Located Within a Hospital: No
Type of Ownership: For profit - Partnership	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: 04/24/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.47

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.97

Number of CNA Hours per Nursing Home Resident per Day: 2.67

Number of Staff Hours per Nursing Home Resident per Day: 4.11

Nursing Home Resident Information**:

Percent of Residents Who Have Moderate to Severe Pain: 13%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 3%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 0%
Percent of Residents Who are More Depressed or Anxious: 8%
Percent of Residents Who Were Physically Restrained: 0%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 5%
Percent of Residents With a Urinary Tract Infection: 10%
** Details Last Reported on: 4/24/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-06-06	2001-07-13	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Actual harm
2001-06-06	2001-07-13	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2001-06-06	2001-07-13	Quality Care Deficiencies	Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.	Isolated	Actual harm
2001-06-06	2001-07-13	Pharmacy Service Deficiencies	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
2001-06-06	2001-07-13	Pharmacy Service Deficiencies	Act when the pharmacist reports something unusual.	Isolated	Minimal harm or potential for actual harm
2001-06-06	2001-07-13	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Pattern	Minimal harm or potential for actual harm
2001-06-06	2001-07-13	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Isolated	Minimal harm or potential for actual harm
2001-06-06	2001-07-13	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
2001-06-06	2001-07-13	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Minimal harm or potential for actual harm
2001-06-06	2001-07-13	Administration Deficiencies	Follow all laws and professional standards.	Widespread	Minimal harm or potential for actual harm
2002-05-30	2002-07-03	Quality Care Deficiencies	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Isolated	Minimal harm or potential for actual harm
2002-05-30	2002-07-03	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
2002-05-30	2002-07-03	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
2002-05-30	2002-07-03	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2002-05-30	2002-07-03	Pharmacy Service Deficiencies	Make sure that the pharmacist reports anything unusual to the doctor on duty and the director of nursing.	Pattern	Minimal harm or potential for actual harm
2002-05-30	2002-07-03	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2003-04-24	2003-05-27	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
2003-04-24	2003-05-27	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
2003-04-24	2003-05-27	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2003-04-24	2003-05-27	Environmental Deficiencies	Keep all essential equipment working safely.	Pattern	Minimal harm or potential for actual harm

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