Country Club Center II

Total Number of Beds: 61	Percent of Occupied Beds: 82%
Total Number of Residents: 50	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 07/09/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.71

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.93

Number of CNA Hours per Nursing Home Resident per Day: 2.34

Number of Staff Hours per Nursing Home Resident per Day: 3.98

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 14%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 11%
Percent of Residents Who Have Moderate to Severe Pain: 12%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 7%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 16%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 9%
Percent of Residents Who are More Depressed or Anxious: 34%
Percent of Short-Stay Residents With Delirium: 0%
Percent of Residents Who Were Physically Restrained: 2%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 55%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 7%
Percent of Residents With a Urinary Tract Infection: 7%
** Details Last Reported on: 7/9/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-02-22	2001-04-12	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
2001-02-22	2001-05-29	Resident Assessment Deficiencies	Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing.	Pattern	Minimal harm or potential for actual harm
2002-04-25	2002-06-13	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
2002-04-25	0000-00-00	Environmental Deficiencies	Keep all essential equipment working safely.	Pattern	Potential for minimal harm
2003-07-09	2003-08-25	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2003-07-09	2003-08-25	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Minimal harm or potential for actual harm

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