Massillon Community Skilled Nursing

Total Number of Beds: 16	Percent of Occupied Beds: 63%
Total Number of Residents: 10	Located Within a Hospital: Yes
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 09/11/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 2.8

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.69

Number of CNA Hours per Nursing Home Resident per Day: 2.52

Number of Staff Hours per Nursing Home Resident per Day: 6.01

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 5%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 36%
Percent of Short-Stay Residents With Delirium: 2%
** Details Last Reported on: 9/11/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-11-08	2001-12-27	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-12-27	Quality Care Deficiencies	Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-12-27	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
2002-12-06	0000-00-00	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2002-12-06	2003-01-25	Resident Assessment Deficiencies	Assess the resident when the resident enters the nursing home, in a timely manner.	Isolated	Minimal harm or potential for actual harm
2002-12-06	2003-01-25	Resident Assessment Deficiencies	Do a new assessment after any major change in a resident's physical or mental health.	Isolated	Minimal harm or potential for actual harm
2002-12-06	2003-01-25	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2002-12-06	2003-01-25	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Isolated	Minimal harm or potential for actual harm
2002-12-06	2003-01-25	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2003-09-11	2003-10-18	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2003-09-11	2003-10-18	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.