Chapman Medical Center D/P Skilled Nursing Facility

Total Number of Beds: 27	Percent of Occupied Beds: 85%
Total Number of Residents: 23	Located Within a Hospital: Yes
Type of Ownership: For 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: 05/30/2003

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**:

** Details Last Reported on: 5/30/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-09-21	2001-10-21	Quality Care Deficiencies	Give proper treatment to residents with feeding tubes to prevent problems (such as aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, nasal-pharyngeal ulcers) and help restore eating skills, if possible.	Isolated	Minimal harm or potential for actual harm
2001-09-21	2001-10-21	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
2001-09-21	2001-10-21	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Isolated	Minimal harm or potential for actual harm
2002-08-01	2002-08-30	Mistreatment Deficiencies	1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents.	Isolated	Minimal harm or potential for actual harm
2002-08-01	2002-08-30	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
2002-08-01	2002-08-30	Resident Assessment Deficiencies	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Pattern	Potential for minimal harm
2003-05-30	2003-06-30	Resident Rights Deficiencies	Bill properly: Charged resident for items that Medicare or Medicaid pays for.	Isolated	Minimal harm or potential for actual harm

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