Worthington Manor, Inc.

Total Number of Beds: 105	Percent of Occupied Beds: 97%
Total Number of Residents: 102	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 04/25/2003

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: 34%
Percent of High-Risk Residents Who Have Pressure Sores: 11%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 3%
Percent of Residents Who Have Moderate to Severe Pain: 3%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 14%
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: 19%
Percent of Residents Who are More Depressed or Anxious: 10%
Percent of Short-Stay Residents With Delirium: 3%
Percent of Residents Who Were Physically Restrained: 13%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 56%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 7%
Percent of Residents With a Urinary Tract Infection: 10%
** Details Last Reported on: 4/25/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-10-11	2001-10-31	Resident Rights Deficiencies	Give the resident's legal representative the same rights as the resident.	Pattern	Minimal harm or potential for actual harm
2001-10-11	2001-11-01	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
2001-10-11	2001-10-31	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Pattern	Minimal harm or potential for actual harm
2001-10-11	2001-10-31	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Pattern	Minimal harm or potential for actual harm
2001-10-11	2001-11-23	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
2001-10-11	2001-11-23	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Pattern	Potential for minimal harm
2001-10-11	2001-10-31	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
2001-10-11	2001-10-31	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
2001-10-11	2001-10-31	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
2001-10-11	2001-10-31	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
2001-10-11	2001-11-23	Environmental Deficiencies	Have a program to keep infection from spreading.	Widespread	Potential for minimal harm
2001-10-11	2001-12-30	Administration Deficiencies	Keep accurate and appropriate medical records.	Widespread	Potential for minimal harm
2002-07-26	0000-00-00	Resident Rights Deficiencies	Give the resident's legal representative the same rights as the resident.	Isolated	Minimal harm or potential for actual harm
2002-07-26	0000-00-00	Resident Rights Deficiencies	Have a private telephone available for use.	Widespread	Potential for minimal harm
2002-07-26	0000-00-00	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Widespread	Potential for minimal harm
2002-07-26	0000-00-00	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
2002-07-26	0000-00-00	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Pattern	Potential for minimal harm
2002-07-26	0000-00-00	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Pattern	Potential for minimal harm
2002-07-26	0000-00-00	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
2002-07-26	0000-00-00	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
2002-07-26	0000-00-00	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Widespread	Potential for minimal harm
2002-07-26	0000-00-00	Administration Deficiencies	Give or get lab tests to meet the needs of residents.	Isolated	Minimal harm or potential for actual harm
2003-04-25	2003-04-26	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
2003-04-25	2003-06-30	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Isolated	Minimal harm or potential for actual harm
2003-04-25	2003-06-15	Resident Assessment Deficiencies	Make sure that all needed doctor visits are made personally by a doctor, as required.	Widespread	Potential for minimal harm
2003-04-25	2003-06-30	Pharmacy Service Deficiencies	Make sure that the pharmacist reports anything unusual to the doctor on duty and the director of nursing.	Widespread	Potential for minimal harm
2003-04-25	2003-06-30	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
2003-04-25	2003-05-27	Administration Deficiencies	Follow all laws and professional standards.	Widespread	Potential for minimal harm

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