Licking Park Manor

Total Number of Beds: 60	Percent of Occupied Beds: 95%
Total Number of Residents: 57	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: 11/08/2002

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.24

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.42

Number of CNA Hours per Nursing Home Resident per Day: 2.65

Number of Staff Hours per Nursing Home Resident per Day: 3.31

Nursing Home Resident Information**:

** Details Last Reported on: 11/8/2002

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-03-30	2001-04-20	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2001-03-30	2001-06-05	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
2001-03-30	2001-06-05	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Isolated	Minimal harm or potential for actual harm
2001-03-30	2001-06-05	Environmental Deficiencies	Put firmly secured handrails on each side of hallways.	Isolated	Minimal harm or potential for actual harm
2002-11-08	2002-12-26	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
2002-11-08	2002-12-26	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

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