Hollis Park Manor Nursing Home

Total Number of Beds: 80	Percent of Occupied Beds: 85%
Total Number of Residents: 68	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	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: 11/14/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.35

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.84

Number of CNA Hours per Nursing Home Resident per Day: 2.11

Number of Staff Hours per Nursing Home Resident per Day: 3.3

Nursing Home Resident Information**:

Percent of Low-Risk Residents Who Have Pressure Sores: 0%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 10%
Percent of Residents Who Have Moderate to Severe Pain: 1%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 6%
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: 6%
Percent of Short-Stay Residents With Delirium: 0%
Percent of Residents Who Were Physically Restrained: 0%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 30%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 3%
Percent of Residents With a Urinary Tract Infection: 3%
** Details Last Reported on: 11/14/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-10-22	2002-03-13	Mistreatment Deficiencies	Protect each resident from all abuse, physical punishment, and being separated from others.	Isolated	Actual harm
2001-10-22	2002-03-13	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
2001-10-22	2002-03-13	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.	Pattern	Minimal harm or potential for actual harm
2001-10-22	2002-03-13	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Pattern	Minimal harm or potential for actual harm
2001-10-22	2002-03-13	Nutrition and Dietary Deficiencies	Make sure that the attending doctor orders special diets.	Pattern	Potential for minimal harm
2001-10-22	2002-03-13	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2002-11-14	2003-01-17	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2002-11-14	2003-01-17	Quality Care Deficiencies	Give each resident a special diet to help when there is a nutritional problem.	Isolated	Minimal harm or potential for actual harm
2002-11-14	2003-01-17	Quality Care Deficiencies	Give each resident enough fluids to keep them healthy and prevent dehydration.	Isolated	Minimal harm or potential for actual harm
2002-11-14	2003-01-17	Quality Care Deficiencies	Give or get dental care for each resident.	Isolated	Minimal harm or potential for actual harm
2002-11-14	2003-01-17	Administration Deficiencies	1) Review the work of each nurse aide every year; or 2) give regular training for the nurse aides.	Isolated	Minimal harm or potential for actual harm
2003-11-14	2003-12-16	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm

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