Evergreen Valley Nursing Home

Total Number of Beds: 89	Percent of Occupied Beds: 96%
Total Number of Residents: 85	Located Within a Hospital: No
Type of Ownership: For profit - Individual	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 01/30/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.63

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.75

Number of CNA Hours per Nursing Home Resident per Day: 1.97

Number of Staff Hours per Nursing Home Resident per Day: 3.35

Nursing Home Resident Information**:

Percent of Low-Risk Residents Who Have Pressure Sores: 3%
Percent of Short-Stay Residents With Pressure Sores: 14%
Percent of High-Risk Residents Who Have Pressure Sores: 6%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 0%
Percent of Residents Who Have Moderate to Severe Pain: 1%
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: 5%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 14%
Percent of Residents Who are More Depressed or Anxious: 17%
Percent of Short-Stay Residents With Delirium: 0%
Percent of Residents Who Were Physically Restrained: 2%
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: 15%
** Details Last Reported on: 1/30/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2000-10-27	2000-12-19	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Pattern	Minimal harm or potential for actual harm
2000-10-27	2000-12-19	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Actual harm
2000-10-27	2000-12-19	Environmental Deficiencies	Provide bedrooms that don't allow residents to see each other when privacy is needed.	Pattern	Potential for minimal harm
2002-01-17	2002-04-15	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Isolated	Minimal harm or potential for actual harm
2002-01-17	2002-04-15	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2002-01-17	2002-04-15	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Pattern	Minimal harm or potential for actual harm
2002-01-17	2002-04-15	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2002-01-17	2002-04-15	Quality Care Deficiencies	Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion.	Isolated	Minimal harm or potential for actual harm
2002-01-17	2002-04-15	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
2002-01-17	2002-04-15	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2003-01-30	2003-03-24	Environmental Deficiencies	Keep temperature levels comfortable and safe.	Pattern	Potential for minimal harm
2003-01-30	2003-03-24	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
2003-01-30	2003-03-24	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
2003-01-30	2003-03-24	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
2003-01-30	2003-03-24	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2003-01-30	2003-03-24	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
2003-01-30	2003-03-24	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm

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