Antelope Vy Hospital Medical Center D P S

Total Number of Beds: 38	Percent of Occupied Beds: 79%
Total Number of Residents: 30	Located Within a Hospital: No
Type of Ownership: Government - Hospital district	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 11/22/2002

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 Short-Stay Residents With Pressure Sores: 44%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 36%
Percent of Short-Stay Residents With Delirium: 0%
** Details Last Reported on: 11/22/2002

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2000-07-14	2000-08-08	Mistreatment Deficiencies	1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents.	Pattern	Potential for minimal harm
2000-07-14	2000-08-08	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Pattern	Potential for minimal harm
2000-07-14	2000-08-08	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Pattern	Potential for minimal harm
2000-07-14	2000-08-08	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
2001-09-28	2001-10-31	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	Potential for minimal harm
2001-09-28	2001-10-31	Quality Care Deficiencies	Make sure that residents with loss of bladder control receive treatment or service to prevent infections and help get normal bladder control.	Pattern	Potential for minimal harm
2001-09-28	2001-10-31	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Potential for minimal harm
2001-09-28	2001-10-31	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
2002-11-22	2003-01-14	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2002-11-22	2003-01-14	Resident Assessment Deficiencies	Assess the resident when the resident enters the nursing home, in a timely manner.	Pattern	Potential for minimal harm
2002-11-22	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	Potential for minimal harm
2002-11-22	2003-01-14	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Pattern	Potential for minimal harm
2002-11-22	2003-01-14	Environmental Deficiencies	Keep all essential equipment working safely.	Pattern	Potential for minimal harm

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