| Total Number of Beds: 120 | Percent of Occupied Beds: 89% |
| Total Number of Residents: 107 | Located Within a Hospital: No |
| Type of Ownership: Non profit - Corporation | Multiple Nursing Homes by Same Owner: No |
| Councils the Nursing Home Participates in: Resident | Medicare/Medicaid: Participating in Medicare and Medicaid |
| * Details Last Reported on: 12/12/2002 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2000-12-28 |
2001-02-20 |
Resident Rights Deficiencies |
Properly hold, secure and manage each resident's personal money which is deposited with the nursing home. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-02-21 |
2002-04-08 |
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. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-02-21 |
2002-04-08 |
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 |
| 2002-02-21 |
2002-04-08 |
Quality Care Deficiencies |
Give professional services that meet a professional standard of quality. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-02-21 |
2002-04-08 |
Quality Care Deficiencies |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-02-21 |
2002-04-08 |
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. |
Widespread |
Minimal harm or potential for actual harm |
| 2002-02-21 |
2002-04-08 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| 2002-12-12 |
2003-01-10 |
Mistreatment Deficiencies |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-12-12 |
2003-01-10 |
Quality Care Deficiencies |
Provide activities to meet the needs of each resident. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-12-12 |
2003-01-10 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.