Pemberton Manor Inc

Total Number of Beds: 120	Percent of Occupied Beds: 85%
Total Number of Residents: 102	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 05/22/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.4

Number of LPN/LVN Hours per Nursing Home Resident per Day: 1.04

Number of CNA Hours per Nursing Home Resident per Day: 2.31

Number of Staff Hours per Nursing Home Resident per Day: 3.75

Nursing Home Resident Information**:

Percent of Low-Risk Residents Who Have Pressure Sores: 2%
Percent of High-Risk Residents Who Have Pressure Sores: 22%
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: 7%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 12%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 7%
Percent of Residents Who are More Depressed or Anxious: 13%
Percent of Residents Who Were Physically Restrained: 8%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 45%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 3%
Percent of Residents With a Urinary Tract Infection: 8%
** Details Last Reported on: 5/22/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-01-31	2001-03-22	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Isolated	Actual harm
2001-01-31	2001-04-16	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Potential for minimal harm
2001-01-31	2001-03-22	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Isolated	Minimal harm or potential for actual harm
2001-01-31	2001-03-22	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
2001-01-31	2001-03-22	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
2001-01-31	2001-03-22	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Isolated	Minimal harm or potential for actual harm
2001-01-31	2001-03-22	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Isolated	Minimal harm or potential for actual harm
2001-01-31	2001-03-22	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Pattern	Minimal harm or potential for actual harm
2001-01-31	2001-03-22	Environmental Deficiencies	Make sure there is a program to prevent/deal with mice, insects, or other pests.	Pattern	Potential for minimal harm
2001-01-31	2001-03-22	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Minimal harm or potential for actual harm
2002-03-21	2002-05-09	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
2002-03-21	2002-05-09	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
2002-03-21	2002-05-09	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2002-03-21	2002-05-09	Environmental Deficiencies	Provide enough emergency electricity.	Pattern	Minimal harm or potential for actual harm
2002-03-21	2002-05-09	Environmental Deficiencies	Make sure there is a program to prevent/deal with mice, insects, or other pests.	Isolated	Minimal harm or potential for actual harm
2002-03-21	2002-05-09	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
2003-05-22	2003-07-31	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
2003-05-22	2003-07-31	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Actual harm
2003-05-22	2003-07-31	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
2003-05-22	2003-07-31	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Isolated	Minimal harm or potential for actual harm

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