| Total Number of Beds: 120 | Percent of Occupied Beds: 97% |
| Total Number of Residents: 116 | Located Within a Hospital: No |
| Type of Ownership: Non profit - Church related | Multiple Nursing Homes by Same Owner: No |
| Councils the Nursing Home Participates in: Family & Resident | Medicare/Medicaid: Participating in Medicare and Medicaid |
| * Details Last Reported on: 11/12/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-10-25 |
2002-01-17 |
Resident Rights Deficiencies |
Provide proof that all residents' personal money which is deposited with the nursing home, is secure. |
Pattern |
Potential for minimal harm |
| 2001-10-25 |
2002-01-17 |
Mistreatment Deficiencies |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Pattern |
Minimal harm or potential for actual harm |
| 2001-10-25 |
2002-01-17 |
Mistreatment Deficiencies |
Protect each resident from all abuse, physical punishment, and being separated from others. |
Pattern |
Minimal harm or potential for actual harm |
| 2001-10-25 |
2002-01-17 |
Quality Care Deficiencies |
Provide activities to meet the needs of each resident. |
Pattern |
Minimal harm or potential for actual harm |
| 2001-10-25 |
2002-01-17 |
Resident Assessment Deficiencies |
Make a complete assessment that covers all questions for areas that are listed in official regulations. |
Pattern |
Minimal harm or potential for actual harm |
| 2001-10-25 |
2002-01-17 |
Quality Care Deficiencies |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-10-25 |
2002-01-17 |
Quality Care Deficiencies |
Make sure that each residents' abilities to take care of themselves does not lessen, unless a change cannot be avoided. |
Pattern |
Minimal harm or potential for actual harm |
| 2001-10-25 |
2002-01-17 |
Quality Care Deficiencies |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Actual harm |
| 2001-10-25 |
2002-01-17 |
Quality Care Deficiencies |
Make sure that each resident's nutritional needs were met. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-10-25 |
2002-01-17 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| 2002-10-21 |
2003-01-06 |
Nutrition and Dietary Deficiencies |
Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. |
Widespread |
Potential for minimal harm |
| 2003-11-12 |
2004-01-31 |
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.