Forest Creek Village

Total Number of Beds: 128	Percent of Occupied Beds: 92%
Total Number of Residents: 118	Located Within a Hospital: No
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 10/06/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.32

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.82

Number of CNA Hours per Nursing Home Resident per Day: 1.59

Number of Staff Hours per Nursing Home Resident per Day: 2.73

Nursing Home Resident Information**:

Percent of Low-Risk Residents Who Have Pressure Sores: 0%
Percent of Short-Stay Residents With Pressure Sores: 12%
Percent of High-Risk Residents Who Have Pressure Sores: 11%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 17%
Percent of Residents Who Have Moderate to Severe Pain: 4%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 24%
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: 24%
Percent of Residents Who are More Depressed or Anxious: 7%
Percent of Short-Stay Residents With Delirium: 0%
Percent of Residents Who Were Physically Restrained: 5%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 46%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 6%
Percent of Residents With a Urinary Tract Infection: 4%
** Details Last Reported on: 10/6/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-08-02	2001-09-02	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Minimal harm or potential for actual harm
2001-08-02	2001-09-02	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2001-08-02	2001-09-02	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2001-08-02	2001-09-02	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
2001-08-02	2001-09-02	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Pattern	Minimal harm or potential for actual harm
2001-08-02	2001-09-02	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Isolated	Minimal harm or potential for actual harm
2001-08-02	2001-09-02	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	Minimal harm or potential for actual harm
2001-08-02	2001-09-02	Administration Deficiencies	Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person.	Pattern	Minimal harm or potential for actual harm
2002-10-25	2002-11-18	Mistreatment Deficiencies	Protect each resident from all abuse, physical punishment, and being separated from others.	Isolated	Minimal harm or potential for actual harm
2002-10-25	2002-11-18	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
2003-10-06	2003-11-07	Resident Rights Deficiencies	Provide written records when a resident is transferred or discharged.	Pattern	Potential for minimal harm
2003-10-06	2003-11-07	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
2003-10-06	2003-11-07	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
2003-10-06	2003-11-07	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
2003-10-06	2003-11-07	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2003-10-06	2003-11-07	Resident Assessment Deficiencies	Develop a plan with the resident and family for the resident's care after leaving the nursing home.	Isolated	Minimal harm or potential for actual harm
2003-10-06	2003-11-07	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Actual harm
2003-10-06	2003-11-07	Quality Care Deficiencies	Give each resident enough fluids to keep them healthy and prevent dehydration.	Isolated	Minimal harm or potential for actual harm
2003-10-06	2003-11-07	Pharmacy Service Deficiencies	Make sure that residents who have not taken antipsychotic drugs are not given these drugs, unless they are used to treat a problem that is diagnosed and noted in the medical record.	Isolated	Minimal harm or potential for actual harm
2003-10-06	2003-11-07	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm

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