Rolling Green Village

Total Number of Beds: 44	Percent of Occupied Beds: 80%
Total Number of Residents: 35	Located Within a Hospital: No
Type of Ownership: Non profit - Other	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 11/13/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.57

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.69

Number of CNA Hours per Nursing Home Resident per Day: 2.68

Number of Staff Hours per Nursing Home Resident per Day: 3.94

Nursing Home Resident Information**:

Percent of Residents Who Have Moderate to Severe Pain: 2%
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: 7%
Percent of Residents Who are More Depressed or Anxious: 12%
Percent of Residents Who Were Physically Restrained: 3%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 0%
Percent of Residents With a Urinary Tract Infection: 3%
** Details Last Reported on: 11/13/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-01-17	2002-02-17	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
2002-01-17	2002-02-17	Resident Assessment Deficiencies	Do a new assessment after any major change in a resident's physical or mental health.	Isolated	Minimal harm or potential for actual harm
2002-01-17	2002-02-17	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2002-10-31	2002-12-01	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	Actual harm
2002-10-31	2002-12-01	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
2003-11-13	2003-12-12	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Isolated	Minimal harm or potential for actual harm
2003-11-13	2003-12-12	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
2003-11-13	2003-12-12	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2003-11-13	2003-12-12	Environmental Deficiencies	Make sure that a working call system is available in each resident's room or bathroom and bathing area.	Pattern	Potential for minimal harm

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