Maple Valley Nursing Home

Total Number of Beds: 25	Percent of Occupied Beds: 96%
Total Number of Residents: 24	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 07/02/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.86

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.62

Number of CNA Hours per Nursing Home Resident per Day: 2.24

Number of Staff Hours per Nursing Home Resident per Day: 3.72

Nursing Home Resident Information**:

** Details Last Reported on: 7/2/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-09-20	2001-11-08	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
2001-09-20	2001-09-24	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Pattern	Potential for minimal harm
2001-09-20	2001-11-08	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Minimal harm or potential for actual harm
2001-09-20	2001-11-08	Nutrition and Dietary Deficiencies	Make sure that the attending doctor orders special diets.	Pattern	Minimal harm or potential for actual harm
2001-09-20	2001-11-08	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Widespread	Minimal harm or potential for actual harm
2002-08-07	2002-10-01	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2002-08-07	2002-10-01	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Actual harm
2002-08-07	2002-10-01	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Minimal harm or potential for actual harm
2003-07-02	2003-08-04	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
2003-07-02	2003-08-04	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm

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