Hickory House Nursing Home

Total Number of Beds: 110	Percent of Occupied Beds: 99%
Total Number of Residents: 109	Located Within a Hospital: No
Type of Ownership: For profit - Partnership	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: 09/05/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.69

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.66

Number of CNA Hours per Nursing Home Resident per Day: 1.84

Number of Staff Hours per Nursing Home Resident per Day: 3.19

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 44%
Percent of High-Risk Residents Who Have Pressure Sores: 14%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 33%
Percent of Residents Who Have Moderate to Severe Pain: 12%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 9%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 1%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 8%
Percent of Residents Who are More Depressed or Anxious: 10%
Percent of Short-Stay Residents With Delirium: 3%
Percent of Residents Who Were Physically Restrained: 0%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 60%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 5%
Percent of Residents With a Urinary Tract Infection: 24%
** Details Last Reported on: 9/5/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-07-19	2001-10-12	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
2001-07-19	2001-10-12	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
2001-07-19	2001-10-12	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2001-07-19	2001-10-12	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
2001-07-19	2001-10-12	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Minimal harm or potential for actual harm
2001-07-19	2001-10-12	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
2002-08-01	2002-10-10	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
2002-08-01	2002-10-10	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2002-08-01	2002-10-10	Administration Deficiencies	Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person.	Widespread	Potential for minimal harm
2003-09-05	2003-10-07	Resident Assessment Deficiencies	Check and update (if needed) each resident's assessment every 3 months.	Isolated	Minimal harm or potential for actual harm
2003-09-05	2003-10-07	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

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