Holstein Good Samaritan Center

Total Number of Beds: 60	Percent of Occupied Beds: 88%
Total Number of Residents: 53	Located Within a Hospital: No
Type of Ownership: Non 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: 08/01/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.54

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.44

Number of CNA Hours per Nursing Home Resident per Day: 2.19

Number of Staff Hours per Nursing Home Resident per Day: 3.17

Nursing Home Resident Information**:

Percent of Residents Who Have Moderate to Severe Pain: 17%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 4%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 4%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 5%
Percent of Residents Who are More Depressed or Anxious: 32%
Percent of Residents Who Were Physically Restrained: 2%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 41%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 3%
Percent of Residents With a Urinary Tract Infection: 10%
** Details Last Reported on: 8/1/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-06-01	2001-08-03	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.	Isolated	Minimal harm or potential for actual harm
2001-06-01	2001-10-02	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
2001-06-01	2001-08-03	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2001-06-01	2001-08-03	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
2001-06-01	2001-08-03	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2001-06-01	2001-10-02	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2001-06-01	2001-08-03	Administration Deficiencies	Follow all laws and professional standards.	Pattern	Minimal harm or potential for actual harm
2001-06-01	2001-08-03	Administration Deficiencies	Hire nurse aides who have completed required training and shown that they are skilled.	Widespread	Minimal harm or potential for actual harm
2002-06-28	2002-07-26	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
2002-06-28	2002-07-26	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
2002-06-28	2002-07-26	Nutrition and Dietary Deficiencies	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
2003-08-01	2003-09-02	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
2003-08-01	2003-09-02	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Actual harm
2003-08-01	2003-09-02	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
2003-08-01	2003-09-02	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Isolated	Minimal harm or potential for actual harm
2003-08-01	2003-09-02	Pharmacy Service Deficiencies	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Widespread	Potential for minimal harm
2003-08-01	2003-09-02	Administration Deficiencies	Follow all laws and professional standards.	Pattern	Minimal harm or potential for actual harm

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