Phillips County Good Sam Retiremen

Total Number of Beds: 48	Percent of Occupied Beds: 58%
Total Number of Residents: 28	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: 10/23/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.91

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.44

Number of CNA Hours per Nursing Home Resident per Day: 2.57

Number of Staff Hours per Nursing Home Resident per Day: 3.92

Nursing Home Resident Information**:

** Details Last Reported on: 10/23/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-07-03	2001-08-08	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2002-10-17	2003-01-16	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Pattern	Potential for minimal harm
2002-10-17	2003-01-16	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Pattern	Minimal harm or potential for actual harm
2002-10-17	2003-01-16	Quality Care Deficiencies	Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.	Pattern	Potential for minimal harm
2003-10-23	2004-01-12	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
2003-10-23	2004-01-12	Quality Care Deficiencies	Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.	Pattern	Minimal harm or potential for actual harm
2003-10-23	2004-01-12	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2003-10-23	2004-01-12	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Pattern	Potential for minimal harm
2003-10-23	2004-01-12	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Widespread	Potential for minimal harm

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