Twelve Oaks Medical Center

Total Number of Beds: 15	Percent of Occupied Beds: 27%
Total Number of Residents: 4	Located Within a Hospital: Yes
Type of Ownership: For profit - Partnership	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 10/07/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 7.43

Number of LPN/LVN Hours per Nursing Home Resident per Day: 4

Number of CNA Hours per Nursing Home Resident per Day: 6

Number of Staff Hours per Nursing Home Resident per Day: 17.43

Nursing Home Resident Information**:

** Details Last Reported on: 10/7/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-11-08	2003-01-10	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Widespread	Potential for minimal harm
2002-11-08	2003-01-10	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
2002-11-08	2003-01-10	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
2002-11-08	2003-01-10	Quality Care Deficiencies	Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion.	Isolated	Actual harm
2002-11-08	2003-01-10	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2002-11-08	2003-01-10	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
2003-10-07	2003-10-08	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm

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