The James B. Haggin Memorial Hospital

Total Number of Beds: 25	Percent of Occupied Beds: 100%
Total Number of Residents: 25	Located Within a Hospital: Yes
Type of Ownership: Non profit - Corporation	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: 12/17/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.68

Number of LPN/LVN Hours per Nursing Home Resident per Day: 2.01

Number of CNA Hours per Nursing Home Resident per Day: 1.83

Number of Staff Hours per Nursing Home Resident per Day: 4.52

Nursing Home Resident Information**:

** Details Last Reported on: 12/17/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-02-27	2002-02-28	Resident Rights Deficiencies	Tell each resident who can get Medicaid benefits about 1) which items and services Medicaid covers and which the resident must pay for; or 2) how to apply for Medicaid, along with the names and addresses of State groups that can help.	Widespread	Potential for minimal harm
2002-02-27	2002-02-27	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Widespread	Potential for minimal harm
2002-02-27	2002-04-03	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
2002-02-27	2002-03-29	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Minimal harm or potential for actual harm
2002-02-27	2002-03-01	Resident Assessment Deficiencies	Do an assessment of the resident every year.	Isolated	Minimal harm or potential for actual harm
2002-02-27	2002-03-29	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Isolated	Minimal harm or potential for actual harm
2002-02-27	2002-04-05	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
2002-02-27	2002-03-29	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Widespread	Minimal harm or potential for actual harm
2002-02-27	2002-04-05	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
2003-01-30	2003-03-10	Resident Rights Deficiencies	Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged.	Pattern	Actual harm
2003-01-30	2003-03-04	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
2003-01-30	2003-03-28	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Actual harm
2003-01-30	2003-03-28	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
2003-01-30	2003-02-28	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2003-01-30	2003-03-28	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Actual harm
2003-01-30	2003-03-16	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Pattern	Actual harm
2003-01-30	2003-03-16	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Isolated	Minimal harm or potential for actual harm
2003-01-30	2003-03-10	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2003-01-30	2003-03-16	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Isolated	Minimal harm or potential for actual harm
2003-01-30	2003-03-16	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2003-01-30	2003-03-28	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
2003-12-17	2004-01-23	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
2003-12-17	2004-01-23	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
2003-12-17	2004-01-23	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2003-12-17	2004-01-23	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm

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