Hickory Creek at Lebanon

Total Number of Beds: 64	Percent of Occupied Beds: 80%
Total Number of Residents: 51	Located Within a Hospital: No
Type of Ownership: Non 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: 05/30/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 1.06

Number of LPN/LVN Hours per Nursing Home Resident per Day: 1.72

Number of CNA Hours per Nursing Home Resident per Day: 1.59

Number of Staff Hours per Nursing Home Resident per Day: 4.37

Nursing Home Resident Information**:

Percent of Low-Risk Residents Who Have Pressure Sores: 6%
Percent of Residents Who Have Moderate to Severe Pain: 13%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 7%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 2%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 28%
Percent of Residents Who are More Depressed or Anxious: 25%
Percent of Residents Who Were Physically Restrained: 13%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 40%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 7%
Percent of Residents With a Urinary Tract Infection: 8%
** Details Last Reported on: 5/30/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-06-26	2001-07-30	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2001-06-26	2001-07-30	Environmental Deficiencies	Keep all essential equipment working safely.	Pattern	Potential for minimal harm
2002-04-19	2002-04-19	Resident Rights Deficiencies	Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged.	Isolated	Minimal harm or potential for actual harm
2002-04-19	2002-05-16	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
2002-04-19	2002-05-16	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Minimal harm or potential for actual harm
2002-04-19	2002-05-16	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
2002-04-19	2002-05-16	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
2002-04-19	2002-05-16	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
2002-04-19	2002-05-16	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2002-04-19	2002-04-19	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Actual harm
2002-04-19	2002-05-16	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
2002-04-19	2002-05-16	Quality Care Deficiencies	Give each resident enough fluids to keep them healthy and prevent dehydration.	Pattern	Minimal harm or potential for actual harm
2002-04-19	2002-05-16	Pharmacy Service Deficiencies	1) Make sure that residents who take drugs are not given too many doses or for too long; 2) make sure that the use of drugs is carefully watched; or 3) stop or change drugs that cause unwanted effects.	Pattern	Minimal harm or potential for actual harm
2002-04-19	2002-05-16	Administration Deficiencies	Make sure that nurse aides show they have the skills to be able to care for residents.	Pattern	Minimal harm or potential for actual harm
2002-04-19	2002-05-16	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Minimal harm or potential for actual harm
2003-05-30	2003-06-30	Resident Rights Deficiencies	Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged.	Isolated	Actual harm
2003-05-30	2003-06-30	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Isolated	Minimal harm or potential for actual harm
2003-05-30	2003-06-30	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
2003-05-30	2003-06-30	Pharmacy Service Deficiencies	1) Make sure that residents who take drugs are not given too many doses or for too long; 2) make sure that the use of drugs is carefully watched; or 3) stop or change drugs that cause unwanted effects.	Isolated	Minimal harm or potential for actual harm
2003-05-30	2003-06-30	Administration Deficiencies	Quickly tell the resident's doctor the results of lab tests.	Isolated	Minimal harm or potential for actual harm

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