Evergreen Lakeport Healthcare

Total Number of Beds: 98	Percent of Occupied Beds: 89%
Total Number of Residents: 87	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 09/25/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day:

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

Number of CNA Hours per Nursing Home Resident per Day:

Number of Staff Hours per Nursing Home Resident per Day:

Nursing Home Resident Information**:

Percent of Low-Risk Residents Who Have Pressure Sores: 5%
Percent of Short-Stay Residents With Pressure Sores: 13%
Percent of High-Risk Residents Who Have Pressure Sores: 21%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 15%
Percent of Residents Who Have Moderate to Severe Pain: 3%
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: 3%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 16%
Percent of Residents Who are More Depressed or Anxious: 21%
Percent of Short-Stay Residents With Delirium: 2%
Percent of Residents Who Were Physically Restrained: 16%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 45%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 1%
Percent of Residents With a Urinary Tract Infection: 5%
** Details Last Reported on: 9/25/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-05-18	2001-09-04	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Pattern	Potential for minimal harm
2001-05-18	2001-09-04	Resident Rights Deficiencies	Let residents talk to and get information from agencies acting on their behalf.	Pattern	Minimal harm or potential for actual harm
2001-05-18	2001-09-04	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
2001-05-18	2001-09-04	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
2001-05-18	2001-09-04	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
2001-05-18	2001-09-04	Resident Assessment Deficiencies	Electronically record and report resident status assessments in a timely manner as required in order to monitor resident health and progress.	Pattern	Minimal harm or potential for actual harm
2001-05-18	2001-09-04	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
2001-05-18	2001-09-04	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
2001-05-18	2001-09-04	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
2001-05-18	2001-09-04	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2001-05-18	2001-09-04	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
2001-05-18	2001-09-04	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Actual harm
2001-05-18	2001-09-04	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	Potential for minimal harm
2001-05-18	2001-09-04	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2001-05-18	2001-09-04	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Pattern	Potential for minimal harm
2001-05-18	2001-09-04	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
2001-05-18	2002-09-04	Pharmacy Service Deficiencies	Act when the pharmacist reports something unusual.	Pattern	Minimal harm or potential for actual harm
2001-05-18	2001-09-28	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
2002-07-26	2002-08-26	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Potential for minimal harm
2002-07-26	2002-08-26	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Potential for minimal harm
2002-07-26	2002-08-26	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
2002-07-26	2002-08-26	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2002-07-26	2002-08-26	Nutrition and Dietary Deficiencies	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Isolated	Minimal harm or potential for actual harm
2002-07-26	2002-08-26	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2002-07-26	2002-08-26	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
2002-07-26	2002-08-26	Administration Deficiencies	Train all employees on what to do in an emergency.	Pattern	Minimal harm or potential for actual harm
2003-09-25	2003-10-30	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.	Pattern	Potential for minimal harm
2003-09-25	2003-10-30	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
2003-09-25	2003-10-30	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Pattern	Minimal harm or potential for actual harm
2003-09-25	2003-10-30	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
2003-09-25	2003-10-30	Environmental Deficiencies	Keep sound levels comfortable.	Pattern	Minimal harm or potential for actual harm
2003-09-25	2003-10-30	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2003-09-25	2003-10-30	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2003-09-25	2003-10-30	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
2003-09-25	2003-10-30	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
2003-09-25	2003-10-30	Quality Care Deficiencies	Give each resident enough fluids to keep them healthy and prevent dehydration.	Isolated	Minimal harm or potential for actual harm
2003-09-25	2003-10-30	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.	Pattern	Potential for minimal harm
2003-09-25	2003-10-30	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
2003-09-25	2003-10-30	Nutrition and Dietary Deficiencies	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
2003-09-25	2003-10-30	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2003-09-25	2003-10-30	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
2003-09-25	2003-10-30	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.