Tri County Retirement & Nursing Home

Total Number of Beds: 58	Percent of Occupied Beds: 91%
Total Number of Residents: 53	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: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 04/09/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.33

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.63

Number of CNA Hours per Nursing Home Resident per Day: 2.61

Number of Staff Hours per Nursing Home Resident per Day: 3.57

Nursing Home Resident Information**:

Percent of Residents Who Have Moderate to Severe Pain: 13%
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: 0%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 8%
Percent of Residents Who are More Depressed or Anxious: 27%
Percent of Residents Who Were Physically Restrained: 0%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 24%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 12%
Percent of Residents With a Urinary Tract Infection: 4%
** Details Last Reported on: 4/9/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-05-17	2001-06-25	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
2002-04-25	2002-05-31	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
2002-04-25	2002-05-31	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2002-04-25	2002-05-31	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
2002-04-25	2002-05-31	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
2002-04-25	2002-05-31	Quality Care Deficiencies	Make sure that residents with loss of bladder control receive treatment or service to prevent infections and help get normal bladder control.	Isolated	Minimal harm or potential for actual harm
2002-04-25	2002-05-31	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.	Isolated	Minimal harm or potential for actual harm
2003-04-09	2003-05-12	Resident Rights Deficiencies	Send and promptly deliver unopened mail to residents.	Isolated	Minimal harm or potential for actual harm
2003-04-09	2003-05-12	Pharmacy Service Deficiencies	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Widespread	Potential for minimal harm
2003-04-09	2003-05-12	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Pattern	Potential for minimal harm

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