Good Samaritan Village

Total Number of Beds: 72	Percent of Occupied Beds: 99%
Total Number of Residents: 71	Located Within a Hospital: No
Type of Ownership: Non 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: 09/11/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.46

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.7

Number of CNA Hours per Nursing Home Resident per Day: 2.13

Number of Staff Hours per Nursing Home Resident per Day: 3.29

Nursing Home Resident Information**:

Percent of High-Risk Residents Who Have Pressure Sores: 7%
Percent of Residents Who Have Moderate to Severe Pain: 2%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 19%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 3%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 12%
Percent of Residents Who are More Depressed or Anxious: 21%
Percent of Residents Who Were Physically Restrained: 1%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 73%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 5%
Percent of Residents With a Urinary Tract Infection: 6%
** Details Last Reported on: 9/11/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-06-07	2001-07-19	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Pattern	Potential for minimal harm
2001-06-07	2001-07-19	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
2001-06-07	2001-07-19	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
2003-09-11	2003-10-08	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
2003-09-11	2003-11-03	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
2003-09-11	2003-11-03	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
2003-09-11	2003-11-03	Quality Care Deficiencies	Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.	Isolated	Minimal harm or potential for actual harm
2003-09-11	2003-11-03	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
2003-09-11	2003-10-08	Pharmacy Service Deficiencies	1) Make sure that residents who take drugs are not given too many doses or for too long; 2) make sure that the use of drugs is carefully watched; or 3) stop or change drugs that cause unwanted effects.	Isolated	Minimal harm or potential for actual harm
2003-09-11	2003-11-03	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Pattern	Potential for minimal harm
2003-09-11	2003-11-03	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm

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