The Forum at Overland Park

Total Number of Beds: 14	Percent of Occupied Beds: 71%
Total Number of Residents: 10	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 Only
* Details Last Reported on: 02/25/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 4.02

Number of LPN/LVN Hours per Nursing Home Resident per Day: 2.43

Number of CNA Hours per Nursing Home Resident per Day: 9.9

Number of Staff Hours per Nursing Home Resident per Day: 16.35

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 4%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 17%
Percent of Short-Stay Residents With Delirium: 0%
** Details Last Reported on: 2/25/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-03-14	2001-04-16	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2001-03-14	2001-04-16	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Isolated	Actual harm
2001-03-14	2001-04-16	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2002-04-11	2002-05-06	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm

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