Provena St Mary's Extended Care

Total Number of Beds: 24	Percent of Occupied Beds: 83%
Total Number of Residents: 20	Located Within a Hospital: Yes
Type of Ownership: Non profit - Church related	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 01/10/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 2.77

Number of LPN/LVN Hours per Nursing Home Resident per Day: 1.06

Number of CNA Hours per Nursing Home Resident per Day: 2.7

Number of Staff Hours per Nursing Home Resident per Day: 6.53

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 32%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 54%
Percent of Short-Stay Residents With Delirium: 0%
** Details Last Reported on: 1/10/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-01-04	2001-02-27	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Isolated	Minimal harm or potential for actual harm
2003-01-10	2003-03-05	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
2003-01-10	2003-03-05	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm

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