Bayshore Community Hospital

Total Number of Beds: 13	Percent of Occupied Beds: 100%
Total Number of Residents: 13	Located Within a Hospital: Yes
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 01/16/2004

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 3.34

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0

Number of CNA Hours per Nursing Home Resident per Day: 1.23

Number of Staff Hours per Nursing Home Resident per Day: 4.57

Nursing Home Resident Information**:

** Details Last Reported on: 1/16/2004

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-07-29	2002-09-15	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Potential for minimal harm
2002-07-29	2002-09-15	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	Potential for minimal harm
2002-07-29	2002-09-15	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2002-07-29	2002-09-15	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
2004-01-16	2004-03-01	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm

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