Shady Lake Nursing Home

Total Number of Beds: 108	Percent of Occupied Beds: 78%
Total Number of Residents: 84	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 08/28/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.31

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.61

Number of CNA Hours per Nursing Home Resident per Day: 2.25

Number of Staff Hours per Nursing Home Resident per Day: 3.17

Nursing Home Resident Information**:

Percent of Low-Risk Residents Who Have Pressure Sores: 0%
Percent of High-Risk Residents Who Have Pressure Sores: 22%
Percent of Residents Who Have Moderate to Severe Pain: 5%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 10%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 10%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 18%
Percent of Residents Who are More Depressed or Anxious: 6%
Percent of Residents Who Were Physically Restrained: 19%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 43%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 4%
Percent of Residents With a Urinary Tract Infection: 9%
** Details Last Reported on: 8/28/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-11-21	0000-00-00	Resident Rights Deficiencies	Properly hold, secure and manage each resident's personal money which is deposited with the nursing home.	Pattern	Potential for minimal harm
2002-11-21	2003-01-14	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Pattern	Minimal harm or potential for actual harm
2002-11-21	0000-00-00	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Widespread	Potential for minimal harm
2002-11-21	0000-00-00	Resident Rights Deficiencies	Have a private telephone available for use.	Pattern	Potential for minimal harm
2002-11-21	2003-01-14	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Mistreatment Deficiencies	Keep each resident free from drugs that restrain them, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Quality Care Deficiencies	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Environmental Deficiencies	Provide clean bed and bath linens that are in good condition.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Widespread	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Resident Assessment Deficiencies	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Isolated	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	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
2002-11-21	2003-01-14	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.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	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
2002-11-21	2003-01-14	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Immediate jeopardy to resident health or safety
2002-11-21	2003-01-14	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Pattern	Immediate jeopardy to resident health or safety
2002-11-21	2003-01-14	Quality Care Deficiencies	Give each resident enough fluids to keep them healthy and prevent dehydration.	Isolated	Actual harm
2002-11-21	2003-01-14	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
2002-11-21	2003-01-14	Nutrition and Dietary Deficiencies	Hire enough skilled workers to carry out dietary service.	Widespread	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Nutrition and Dietary Deficiencies	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Widespread	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2002-11-21	0000-00-00	Environmental Deficiencies	Get rid of garbage properly.	Pattern	Potential for minimal harm
2002-11-21	2003-01-14	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Environmental Deficiencies	Provide bedrooms that don't allow residents to see each other when privacy is needed.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Environmental Deficiencies	Make sure that a working call system is available in each resident's room or bathroom and bathing area.	Pattern	Immediate jeopardy to resident health or safety
2002-11-21	2003-01-14	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Environmental Deficiencies	Make sure there is a program to prevent/deal with mice, insects, or other pests.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Administration Deficiencies	1) Review the work of each nurse aide every year; or 2) give regular training for the nurse aides.	Pattern	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Administration Deficiencies	Choose a doctor to be the medical director.	Widespread	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Administration Deficiencies	Set up or keep a group of people to review and ensure quality.	Widespread	Minimal harm or potential for actual harm
2002-11-21	2003-01-14	Administration Deficiencies	Hold committee meetings every 3 months to review and ensure quality in the nursing home.	Widespread	Minimal harm or potential for actual harm
2003-08-28	0000-00-00	Resident Rights Deficiencies	Properly hold, secure and manage each resident's personal money which is deposited with the nursing home.	Pattern	Potential for minimal harm
2003-08-28	0000-00-00	Resident Rights Deficiencies	Bill properly: Charged resident for items that Medicare or Medicaid pays for.	Pattern	Potential for minimal harm
2003-08-28	2003-10-12	Resident Assessment Deficiencies	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Isolated	Minimal harm or potential for actual harm
2003-08-28	2003-10-12	Pharmacy Service Deficiencies	Act when the pharmacist reports something unusual.	Pattern	Minimal harm or potential for actual harm
2003-08-28	2003-10-12	Environmental Deficiencies	Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection.	Widespread	Minimal harm or potential for actual harm
2003-08-28	2003-10-12	Administration Deficiencies	Make sure that nurse aides show they have the skills to be able to care for residents.	Isolated	Minimal harm or potential for actual harm
2003-08-28	2003-10-12	Administration Deficiencies	Train all employees on what to do in an emergency.	Pattern	Minimal harm or potential for actual harm

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