Ambassador Good Samaritan Center

Total Number of Beds: 85	Percent of Occupied Beds: Not Available%
Total Number of Residents: 86	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: 01/09/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day:

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

Number of CNA Hours per Nursing Home Resident per Day:

Number of Staff Hours per Nursing Home Resident per Day:

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 10%
Percent of High-Risk Residents Who Have Pressure Sores: 8%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 16%
Percent of Residents Who Have Moderate to Severe Pain: 4%
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: 0%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 7%
Percent of Residents Who are More Depressed or Anxious: 10%
Percent of Short-Stay Residents With Delirium: 4%
Percent of Residents Who Were Physically Restrained: 3%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 70%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 5%
Percent of Residents With a Urinary Tract Infection: 5%
** Details Last Reported on: 1/9/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2000-10-26	2000-12-18	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2000-10-26	2000-12-18	Quality Care Deficiencies	Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.	Isolated	Minimal harm or potential for actual harm
2000-10-26	2000-12-18	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2000-10-26	2000-12-18	Administration Deficiencies	Train all employees on what to do in an emergency.	Pattern	Minimal harm or potential for actual harm
2001-11-08	2001-11-28	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-12-07	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
2001-11-08	2001-11-28	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2002-01-07	Quality Care Deficiencies	Make sure that residents with loss of bladder control receive treatment or service to prevent infections and help get normal bladder control.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-11-29	Quality Care Deficiencies	Give each resident a special diet to help when there is a nutritional problem.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-11-29	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-12-18	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
2001-11-08	2002-01-07	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Isolated	Minimal harm or potential for actual harm
2001-11-08	2001-12-18	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Minimal harm or potential for actual harm
2001-11-08	2001-11-19	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Minimal harm or potential for actual harm
2003-01-09	2003-01-31	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Minimal harm or potential for actual harm
2003-01-09	2003-02-20	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2003-01-09	2003-02-20	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
2003-01-09	2003-02-20	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Isolated	Minimal harm or potential for actual harm
2003-01-09	2003-02-20	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm

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