Clc Polk City

Total Number of Beds: 68	Percent of Occupied Beds: 82%
Total Number of Residents: 56	Located Within a Hospital: No
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: 05/16/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.61

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.46

Number of CNA Hours per Nursing Home Resident per Day: 1.62

Number of Staff Hours per Nursing Home Resident per Day: 2.69

Nursing Home Resident Information**:

Percent of Residents Who Have Moderate to Severe Pain: 0%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 10%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 2%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 2%
Percent of Residents Who are More Depressed or Anxious: 20%
Percent of Residents Who Were Physically Restrained: 2%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 59%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 14%
Percent of Residents With a Urinary Tract Infection: 8%
** Details Last Reported on: 5/16/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-04-13	2001-06-27	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Isolated	Minimal harm or potential for actual harm
2001-04-13	2001-07-30	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
2001-04-13	2001-06-27	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
2001-04-13	2001-06-27	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2001-04-13	2001-07-30	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Actual harm
2001-04-13	2001-06-27	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
2001-04-13	2001-06-27	Nutrition and Dietary Deficiencies	1) Provide 3 meals daily at regular times; or 2) serve breakfast within 14 hours after dinner; or 3) offer a snack at bedtime each day.	Widespread	Minimal harm or potential for actual harm
2002-04-04	2002-05-04	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2002-04-04	2002-05-04	Resident Assessment Deficiencies	Provide a final summary of the resident's health status and a summary of the resident's stay, when the resident is ready to leave the nursing home.	Isolated	Minimal harm or potential for actual harm
2002-04-04	2002-05-04	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2003-05-16	2003-06-12	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Isolated	Minimal harm or potential for actual harm
2003-05-16	2003-06-12	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
2003-05-16	2003-06-12	Pharmacy Service Deficiencies	Make sure that residents who have not taken antipsychotic drugs are not given these drugs, unless they are used to treat a problem that is diagnosed and noted in the medical record.	Isolated	Minimal harm or potential for actual harm

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