Mary J Brown Good Sam Center

Total Number of Beds: 68	Percent of Occupied Beds: 82%
Total Number of Residents: 56	Located Within a Hospital: No
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 08/21/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.63

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.57

Number of CNA Hours per Nursing Home Resident per Day: 2.08

Number of Staff Hours per Nursing Home Resident per Day: 3.28

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 13%
Percent of High-Risk Residents Who Have Pressure Sores: 16%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 43%
Percent of Residents Who Have Moderate to Severe Pain: 23%
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: 23%
Percent of Residents Who are More Depressed or Anxious: 25%
Percent of Short-Stay Residents With Delirium: 6%
Percent of Residents Who Were Physically Restrained: 8%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 53%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 9%
Percent of Residents With a Urinary Tract Infection: 8%
** Details Last Reported on: 8/21/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-07-19	2001-07-20	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
2001-07-19	2001-08-06	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2002-09-06	2002-10-02	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Pattern	Minimal harm or potential for actual harm
2003-08-21	2003-10-06	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
2003-08-21	2003-10-06	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
2003-08-21	2003-10-06	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2003-08-21	2003-10-06	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm

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