Maple Grove Health Care Center

Total Number of Beds: 60	Percent of Occupied Beds: 93%
Total Number of Residents: 56	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: 09/04/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.21

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.89

Number of CNA Hours per Nursing Home Resident per Day: 1.83

Number of Staff Hours per Nursing Home Resident per Day: 2.93

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 29%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 21%
Percent of Residents Who Have Moderate to Severe Pain: 17%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 20%
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: 19%
Percent of Residents Who are More Depressed or Anxious: 2%
Percent of Short-Stay Residents With Delirium: 2%
Percent of Residents Who Were Physically Restrained: 7%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 4%
Percent of Residents With a Urinary Tract Infection: 29%
** Details Last Reported on: 9/4/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-10-10	0000-00-00	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2002-10-10	0000-00-00	Resident Assessment Deficiencies	Make sure that doctors visit residents regularly, as required.	Isolated	Minimal harm or potential for actual harm
2002-10-10	0000-00-00	Pharmacy Service Deficiencies	Act when the pharmacist reports something unusual.	Isolated	Minimal harm or potential for actual harm
2003-09-04	0000-00-00	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
2003-09-04	0000-00-00	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
2003-09-04	0000-00-00	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
2003-09-04	0000-00-00	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
2003-09-04	0000-00-00	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm

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