Van Dyk Manor Montclair

Total Number of Beds: 68	Percent of Occupied Beds: 81%
Total Number of Residents: 55	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 09/04/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.61

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.55

Number of CNA Hours per Nursing Home Resident per Day: 2.93

Number of Staff Hours per Nursing Home Resident per Day: 4.09

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 20%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 11%
Percent of Short-Stay Residents With Delirium: 2%
** Details Last Reported on: 9/4/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-07-12	2001-08-30	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2001-07-12	2001-08-30	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
2001-07-12	2001-08-30	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2001-07-12	2001-08-30	Pharmacy Service Deficiencies	Make sure that residents are safe from serious medication errors.	Isolated	Minimal harm or potential for actual harm
2001-07-12	2001-08-30	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2001-07-12	2001-08-30	Environmental Deficiencies	Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection.	Widespread	Minimal harm or potential for actual harm
2001-07-12	2001-08-30	Environmental Deficiencies	Keep all essential equipment working safely.	Pattern	Minimal harm or potential for actual harm
2001-07-12	2001-08-30	Environmental Deficiencies	Make sure that a working call system is available in each resident's room or bathroom and bathing area.	Widespread	Minimal harm or potential for actual harm
2001-07-12	2001-08-30	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
2002-09-19	2002-11-04	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm

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