Evergreen Manor Nursing Home

Total Number of Beds: 73	Percent of Occupied Beds: 100%
Total Number of Residents: 73	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 and Medicaid
* Details Last Reported on: 07/10/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.38

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.47

Number of CNA Hours per Nursing Home Resident per Day: 1.07

Number of Staff Hours per Nursing Home Resident per Day: 1.92

Nursing Home Resident Information**:

Percent of High-Risk Residents Who Have Pressure Sores: 12%
Percent of Residents Who Have Moderate to Severe Pain: 10%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 16%
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: 19%
Percent of Residents Who are More Depressed or Anxious: 46%
Percent of Residents Who Were Physically Restrained: 3%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 28%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 10%
Percent of Residents With a Urinary Tract Infection: 4%
** Details Last Reported on: 7/10/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-07-12	2001-08-14	Resident Rights Deficiencies	Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged.	Isolated	Minimal harm or potential for actual harm
2001-07-12	2001-08-14	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2001-07-12	2001-08-14	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Potential for minimal harm
2001-07-12	2001-08-14	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
2001-07-12	2001-08-14	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Widespread	Potential for minimal harm
2001-07-12	2001-08-14	Administration Deficiencies	Give or get lab tests to meet the needs of residents.	Isolated	Minimal harm or potential for actual harm
2001-07-12	2001-08-14	Deficiencies Reported Between Inspections	Comply with program requirements between annual inspections; although it corrected these problems before the most recent inspection.	Isolated	Actual harm
2002-09-19	2002-11-08	Resident Rights Deficiencies	Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged.	Isolated	Minimal harm or potential for actual harm
2002-09-19	2002-11-08	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
2002-09-19	2002-11-26	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Widespread	Potential for minimal harm
2002-09-19	2003-01-15	Quality Care Deficiencies	Use a registered nurse at least 8 hours a day, 7 days a week.	Pattern	Potential for minimal harm
2002-09-19	2002-11-26	Administration Deficiencies	1) Review the work of each nurse aide every year; or 2) give regular training for the nurse aides.	Widespread	Potential for minimal harm
2003-07-10	2003-09-02	Resident Assessment Deficiencies	1) Develop a complete care plan within 7 days of each resident's admission; 2) prepare a care plan with the care team, including the primary nurse, doctor, resident or resident's family or representative; or 3) check and update the care plan.	Isolated	Minimal harm or potential for actual harm
2003-07-10	2003-09-25	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2003-07-10	2003-09-02	Quality Care Deficiencies	Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.	Pattern	Minimal harm or potential for actual harm
2003-07-10	2003-08-29	Quality Care Deficiencies	Use a registered nurse at least 8 hours a day, 7 days a week.	Pattern	Potential for minimal harm
2003-07-10	2003-09-25	Pharmacy Service Deficiencies	Act when the pharmacist reports something unusual.	Isolated	Minimal harm or potential for actual harm
2003-07-10	2003-09-02	Administration Deficiencies	1) Review the work of each nurse aide every year; or 2) give regular training for the nurse aides.	Pattern	Potential for minimal harm
2003-07-10	2003-09-25	Administration Deficiencies	Give or get lab tests to meet the needs of residents.	Isolated	Minimal harm or potential for actual harm

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