Oak Grove Manor, Inc.

Total Number of Beds: 96	Percent of Occupied Beds: 30%
Total Number of Residents: 29	Located Within a Hospital: No
Type of Ownership: For 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: 10/22/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.37

Number of LPN/LVN Hours per Nursing Home Resident per Day: 1.13

Number of CNA Hours per Nursing Home Resident per Day: 3.56

Number of Staff Hours per Nursing Home Resident per Day: 5.06

Nursing Home Resident Information**:

** Details Last Reported on: 10/22/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-01-17	2002-02-25	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
2002-01-17	2002-02-25	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
2002-01-17	2002-02-25	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
2002-01-17	2002-02-25	Quality Care Deficiencies	Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion.	Isolated	Minimal harm or potential for actual harm
2002-01-17	2002-02-25	Nutrition and Dietary Deficiencies	1) Provide 3 meals daily at regular times; or 2) serve breakfast within 14 hours after dinner; or 3) offer a snack at bedtime each day.	Pattern	Minimal harm or potential for actual harm
2003-01-24	2003-01-25	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Actual harm
2003-01-24	2003-01-24	Environmental Deficiencies	Keep temperature levels comfortable and safe.	Pattern	Minimal harm or potential for actual harm
2003-01-24	2003-01-31	Quality Care Deficiencies	Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.	Isolated	Minimal harm or potential for actual harm
2003-01-24	2003-03-10	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Pattern	Minimal harm or potential for actual harm
2003-01-24	2003-03-10	Nutrition and Dietary Deficiencies	Offer other nutritional food to each resident who will not eat the food served.	Isolated	Minimal harm or potential for actual harm
2003-01-24	2003-03-10	Nutrition and Dietary Deficiencies	1) Provide 3 meals daily at regular times; or 2) serve breakfast within 14 hours after dinner; or 3) offer a snack at bedtime each day.	Pattern	Minimal harm or potential for actual harm
2003-01-24	2003-01-31	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Widespread	Minimal harm or potential for actual harm
2003-01-24	2003-01-24	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Immediate jeopardy to resident health or safety
2003-01-24	2003-03-10	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Minimal harm or potential for actual harm
2003-10-22	2003-12-02	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Isolated	Minimal harm or potential for actual harm
2003-10-22	2003-11-30	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Pattern	Potential for minimal harm
2003-10-22	2003-12-02	Resident Assessment Deficiencies	Do a new assessment after any major change in a resident's physical or mental health.	Isolated	Minimal harm or potential for actual harm
2003-10-22	2003-11-30	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
2003-10-22	2003-10-23	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2003-10-22	2003-12-02	Resident Assessment Deficiencies	Make sure that doctors visit residents regularly, as required.	Pattern	Minimal harm or potential for actual harm

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