Evergreen Hot Springs Health

Total Number of Beds: 64	Percent of Occupied Beds: 42%
Total Number of Residents: 27	Located Within a Hospital: No
Type of Ownership: For 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: 06/05/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.43

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.09

Number of CNA Hours per Nursing Home Resident per Day: 0.89

Number of Staff Hours per Nursing Home Resident per Day: 1.41

Nursing Home Resident Information**:

** Details Last Reported on: 6/5/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-08-01	2001-09-17	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
2002-09-19	2002-10-24	Resident Assessment Deficiencies	Make sure that doctors visit residents regularly, as required.	Pattern	Potential for minimal harm
2003-06-05	2003-08-19	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.	Pattern	Minimal harm or potential for actual harm
2003-06-05	2003-08-19	Resident Assessment Deficiencies	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Pattern	Minimal harm or potential for actual harm
2003-06-05	2003-08-19	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Pattern	Minimal harm or potential for actual harm
2003-06-05	2003-08-19	Quality Care Deficiencies	Give proper treatment to residents with feeding tubes to prevent problems (such as aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, nasal-pharyngeal ulcers) and help restore eating skills, if possible.	Isolated	Minimal harm or potential for actual harm
2003-06-05	2003-08-19	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Pattern	Minimal harm or potential for actual harm
2003-06-05	2003-08-19	Nutrition and Dietary Deficiencies	Get food from approved places.	Widespread	Potential for minimal harm
2003-06-05	2003-08-19	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Pattern	Potential for minimal harm
2003-06-05	2003-08-19	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Isolated	Minimal harm or potential for actual harm
2003-06-05	2003-08-19	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Pattern	Potential for minimal harm

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