Pine Tree Villa

Total Number of Beds: 70	Percent of Occupied Beds: 96%
Total Number of Residents: 67	Located Within a Hospital: No
Type of Ownership: For profit - Individual	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: 09/23/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.64

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.43

Number of CNA Hours per Nursing Home Resident per Day: 1.52

Number of Staff Hours per Nursing Home Resident per Day: 2.59

Nursing Home Resident Information**:

Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 24%
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: 13%
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: 38%
Percent of Residents Who are More Depressed or Anxious: 18%
Percent of Short-Stay Residents With Delirium: 4%
Percent of Residents Who Were Physically Restrained: 21%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 3%
Percent of Residents With a Urinary Tract Infection: 2%
** Details Last Reported on: 9/23/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-08-29	2001-09-19	Resident Rights Deficiencies	Provide enough notice before discharging or transferring a resident.	Isolated	Minimal harm or potential for actual harm
2001-08-29	2001-10-02	Mistreatment Deficiencies	1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents.	Isolated	Minimal harm or potential for actual harm
2001-08-29	2001-10-12	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Minimal harm or potential for actual harm
2001-08-29	2001-10-13	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Isolated	Minimal harm or potential for actual harm
2001-08-29	2001-10-08	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
2001-08-29	2001-10-04	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2001-08-29	2001-10-01	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
2001-08-29	2001-10-01	Nutrition and Dietary Deficiencies	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
2001-08-29	2001-10-04	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2001-08-29	2001-09-07	Environmental Deficiencies	Get rid of garbage properly.	Widespread	Minimal harm or potential for actual harm
2001-08-29	2001-10-04	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
2001-08-29	2001-10-04	Environmental Deficiencies	Keep all essential equipment working safely.	Isolated	Minimal harm or potential for actual harm
2001-08-29	2001-10-04	Administration Deficiencies	Follow all laws and professional standards.	Isolated	Minimal harm or potential for actual harm
2002-09-26	2002-10-31	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
2002-09-26	2002-10-31	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Isolated	Minimal harm or potential for actual harm
2002-09-26	2002-10-31	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2002-09-26	2002-10-31	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
2002-09-26	2002-10-31	Quality Care Deficiencies	Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.	Isolated	Minimal harm or potential for actual harm
2002-09-26	2002-10-31	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
2002-09-26	2002-10-31	Nutrition and Dietary Deficiencies	Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	Pattern	Minimal harm or potential for actual harm
2002-09-26	2002-10-31	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2002-09-26	2002-10-31	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
2003-09-23	2003-11-06	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2003-09-23	2003-11-06	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Minimal harm or potential for actual harm
2003-09-23	2003-11-06	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	Actual harm
2003-09-23	2003-11-06	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.	Pattern	Minimal harm or potential for actual harm
2003-09-23	2003-11-06	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Pattern	Minimal harm or potential for actual harm
2003-09-23	2003-11-06	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
2003-09-23	2003-11-06	Quality Care Deficiencies	Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.	Isolated	Minimal harm or potential for actual harm
2003-09-23	2003-11-06	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2003-09-23	2003-11-07	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Immediate jeopardy to resident health or safety
2003-09-23	2003-09-27	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Pattern	Immediate jeopardy to resident health or safety
2003-09-23	2003-11-06	Nutrition and Dietary Deficiencies	Provide food in a way that meets a resident's needs.	Isolated	Minimal harm or potential for actual harm
2003-09-23	2003-11-07	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2003-09-23	2003-11-06	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Widespread	Potential for minimal harm
2003-09-23	2003-11-06	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2003-09-23	2003-11-06	Environmental Deficiencies	Put firmly secured handrails on each side of hallways.	Widespread	Potential for minimal harm
2003-09-23	2003-11-06	Administration Deficiencies	Be administered in a way that leads to the highest possible level of well being for each resident.	Widespread	Minimal harm or potential for actual harm
2003-09-23	2003-11-07	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
2003-09-23	2003-11-06	Administration Deficiencies	Hold committee meetings every 3 months to review and ensure quality in the nursing home.	Widespread	Minimal harm or potential for actual harm

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