North Central Good Samaritan Center

Total Number of Beds: 61	Percent of Occupied Beds: 84%
Total Number of Residents: 51	Located Within a Hospital: No
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 05/21/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.78

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.46

Number of CNA Hours per Nursing Home Resident per Day: 2.32

Number of Staff Hours per Nursing Home Resident per Day: 3.56

Nursing Home Resident Information**:

Percent of Residents Who Have Moderate to Severe Pain: 6%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 15%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 0%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 10%
Percent of Residents Who are More Depressed or Anxious: 45%
Percent of Residents Who Were Physically Restrained: 0%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 44%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 4%
Percent of Residents With a Urinary Tract Infection: 8%
** Details Last Reported on: 5/21/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-07-12	2001-07-20	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Widespread	Potential for minimal harm
2001-07-12	2001-07-20	Environmental Deficiencies	Have enough outside airflow.	Pattern	Potential for minimal harm
2002-06-19	2002-07-18	Quality Care Deficiencies	Give each resident enough fluids to keep them healthy and prevent dehydration.	Pattern	Minimal harm or potential for actual harm
2002-06-19	2002-07-26	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2003-05-21	2003-06-26	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Pattern	Potential for minimal harm
2003-05-21	2003-06-26	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm

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