| Total Number of Beds: 113 | Percent of Occupied Beds: 92% |
| Total Number of Residents: 104 | Located Within a Hospital: No |
| Type of Ownership: For 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: 10/17/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-11-30 |
2001-12-01 |
Nutrition and Dietary Deficiencies |
Provide food in a way that meets a resident's needs. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-11-30 |
2002-01-09 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Potential for minimal harm |
| 2002-11-15 |
2002-12-17 |
Mistreatment Deficiencies |
Keep each resident free from physical restraints, unless needed for medical treatment. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-11-15 |
2002-12-17 |
Mistreatment Deficiencies |
Protect each resident from all abuse, physical punishment, and being separated from others. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-11-15 |
2002-12-17 |
Administration Deficiencies |
Hire a qualified activities director. |
Widespread |
Potential for minimal harm |
| 2002-11-15 |
2002-12-17 |
Environmental Deficiencies |
Provide needed housekeeping and maintenance. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-11-15 |
2002-12-17 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| 2002-11-15 |
2002-12-17 |
Environmental Deficiencies |
Get rid of garbage properly. |
Widespread |
Potential for minimal harm |
| 2002-11-15 |
2002-12-17 |
Administration Deficiencies |
Make sure that nurse aides show they have the skills to be able to care for residents. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-11-15 |
2002-12-17 |
Administration Deficiencies |
Set up or keep a group of people to review and ensure quality. |
Widespread |
Potential for minimal harm |
| 2002-11-15 |
2002-12-17 |
Administration Deficiencies |
Hold committee meetings every 3 months to review and ensure quality in the nursing home. |
Widespread |
Potential for minimal harm |
| 2003-10-17 |
2003-11-14 |
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 |
| 2003-10-17 |
2003-11-14 |
Administration Deficiencies |
Make sure that nurse aides show they have the skills to be able to care for residents. |
Pattern |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.