Statesman Health and Rehab Center

Total Number of Beds: 101	Percent of Occupied Beds: 97%
Total Number of Residents: 98	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: 05/29/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.66

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.75

Number of CNA Hours per Nursing Home Resident per Day: 1.64

Number of Staff Hours per Nursing Home Resident per Day: 3.05

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 21%
Percent of High-Risk Residents Who Have Pressure Sores: 25%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 18%
Percent of Residents Who Have Moderate to Severe Pain: 10%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 13%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 16%
Percent of Residents Who are More Depressed or Anxious: 4%
Percent of Short-Stay Residents With Delirium: 4%
Percent of Residents Who Were Physically Restrained: 4%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 54%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 10%
Percent of Residents With a Urinary Tract Infection: 17%
** Details Last Reported on: 5/29/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-05-04	2001-07-26	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2001-05-04	2001-05-04	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Isolated	Minimal harm or potential for actual harm
2001-05-04	2001-06-29	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Minimal harm or potential for actual harm
2001-05-04	2001-07-26	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
2001-05-04	2001-07-26	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
2001-05-04	2001-06-29	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
2001-05-04	2001-06-29	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Widespread	Potential for minimal harm
2002-04-05	2002-04-25	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
2002-04-05	2002-04-25	Quality Care Deficiencies	Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion.	Isolated	Minimal harm or potential for actual harm
2002-04-05	2002-04-25	Administration Deficiencies	Choose a doctor to be the medical director.	Widespread	Minimal harm or potential for actual harm
2003-05-29	2003-07-17	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.	Pattern	Potential for minimal harm
2003-05-29	2003-07-17	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Widespread	Potential for minimal harm
2003-05-29	2003-07-17	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
2003-05-29	2003-07-17	Pharmacy Service Deficiencies	Act when the pharmacist reports something unusual.	Isolated	Minimal harm or potential for actual harm
2003-05-29	2003-07-17	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2003-05-29	2003-07-17	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Isolated	Minimal harm or potential for actual harm
2003-05-29	2003-07-17	Administration Deficiencies	Get services outside the nursing home that meet professional standards.	Isolated	Minimal harm or potential for actual harm
2003-05-29	2003-07-17	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm

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