Victory Lake Nursing Center

Total Number of Beds: 120	Percent of Occupied Beds: 70%
Total Number of Residents: 84	Located Within a Hospital: No
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 10/29/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.48

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.88

Number of CNA Hours per Nursing Home Resident per Day: 0

Number of Staff Hours per Nursing Home Resident per Day: 1.36

Nursing Home Resident Information**:

Percent of Low-Risk Residents Who Have Pressure Sores: 2%
Percent of Short-Stay Residents With Pressure Sores: 20%
Percent of High-Risk Residents Who Have Pressure Sores: 11%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 39%
Percent of Residents Who Have Moderate to Severe Pain: 2%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 17%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 0%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 17%
Percent of Residents Who are More Depressed or Anxious: 10%
Percent of Short-Stay Residents With Delirium: 0%
Percent of Residents Who Were Physically Restrained: 11%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 40%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 0%
Percent of Residents With a Urinary Tract Infection: 3%
** Details Last Reported on: 10/29/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-12-11	2002-02-22	Resident Rights Deficiencies	Tell each resident who can get Medicaid benefits about 1) which items and services Medicaid covers and which the resident must pay for; or 2) how to apply for Medicaid, along with the names and addresses of State groups that can help.	Isolated	Minimal harm or potential for actual harm
2001-12-11	2002-03-27	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
2001-12-11	2002-03-27	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	Actual harm
2001-12-11	2002-03-27	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Pattern	Minimal harm or potential for actual harm
2001-12-11	2002-03-27	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Actual harm
2001-12-11	2002-03-27	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
2001-12-11	2002-03-27	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Widespread	Minimal harm or potential for actual harm
2001-12-11	2002-03-27	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
2001-12-11	2002-03-27	Quality Care Deficiencies	Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.	Pattern	Minimal harm or potential for actual harm
2001-12-11	2002-03-27	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
2001-12-11	2002-03-27	Quality Care Deficiencies	Give the right treatment and services to residents who have mental or social problems adjusting.	Pattern	Minimal harm or potential for actual harm
2001-12-11	2002-03-27	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
2001-12-11	2002-03-27	Quality Care Deficiencies	Give each resident enough fluids to keep them healthy and prevent dehydration.	Isolated	Actual harm
2001-12-11	2002-03-27	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Isolated	Minimal harm or potential for actual harm
2001-12-11	2002-02-22	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2001-12-11	2002-03-27	Quality Care Deficiencies	Give or get dental care for each resident.	Isolated	Minimal harm or potential for actual harm
2001-12-11	2002-03-27	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Pattern	Minimal harm or potential for actual harm
2001-12-11	2002-02-22	Environmental Deficiencies	Make sure that a working call system is available in each resident's room or bathroom and bathing area.	Isolated	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	Resident Rights Deficiencies	Let the resident refuse treatment or refuse to take part in an experiment.	Isolated	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	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
2002-10-29	2003-01-15	Resident Rights Deficiencies	Make sure each resident has the right to choose activities, schedules and health care according to his or her interests, assessment, and plan of care.	Pattern	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Pattern	Minimal harm or potential for actual harm
2002-10-29	2002-11-25	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2002-10-29	2003-01-15	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	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.	Isolated	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	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
2002-10-29	2003-01-15	Quality Care Deficiencies	Give the right treatment and services to residents who have mental or social problems adjusting.	Isolated	Minimal harm or potential for actual harm
2002-10-29	2003-03-11	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	Quality Care Deficiencies	Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	Isolated	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	Nutrition and Dietary Deficiencies	Hire a qualified dietician.	Isolated	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Isolated	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	Quality Care Deficiencies	Give or get special rehabilitation if in the patient's plan of care.	Pattern	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	Pharmacy Service Deficiencies	Make sure that the pharmacist reports anything unusual to the doctor on duty and the director of nursing.	Isolated	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	Administration Deficiencies	Be administered in a way that leads to the highest possible level of well being for each resident.	Isolated	Actual harm
2002-10-29	2003-01-15	Administration Deficiencies	1) Set up a group that is legally responsible for writing and setting up policies for leading and running the nursing home; or 2) hire a properly licensed administrator.	Isolated	Actual harm
2002-10-29	2003-01-15	Administration Deficiencies	Get services outside the nursing home that meet professional standards.	Isolated	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	Administration Deficiencies	Choose a doctor to be the medical director.	Isolated	Actual harm
2002-10-29	2003-03-11	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
2002-10-29	2003-01-15	Administration Deficiencies	Have a detailed, written plan for disasters and emergencies.	Pattern	Potential for minimal harm
2002-10-29	2003-01-15	Administration Deficiencies	Train all employees on what to do in an emergency.	Pattern	Minimal harm or potential for actual harm
2003-10-29	2003-11-30	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Isolated	Minimal harm or potential for actual harm
2003-10-29	2003-11-30	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
2003-10-29	2003-11-30	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2003-10-29	2003-11-30	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Pattern	Minimal harm or potential for actual harm
2003-10-29	2003-11-30	Administration Deficiencies	Have a detailed, written plan for disasters and emergencies.	Pattern	Minimal harm or potential for actual harm

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