Pontotoc Health Services Skilled Nursing Facility

Total Number of Beds: 10	Percent of Occupied Beds: 50%
Total Number of Residents: 5	Located Within a Hospital: Yes
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 12/11/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 2.23

Number of LPN/LVN Hours per Nursing Home Resident per Day: 3.66

Number of CNA Hours per Nursing Home Resident per Day: 5.09

Number of Staff Hours per Nursing Home Resident per Day: 10.98

Nursing Home Resident Information**:

** Details Last Reported on: 12/11/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-03-01	2002-03-07	Resident Assessment Deficiencies	1) Develop a complete care plan within 7 days of each resident's admission; 2) prepare a care plan with the care team, including the primary nurse, doctor, resident or resident's family or representative; or 3) check and update the care plan.	Widespread	Potential for minimal harm
2002-03-01	2002-03-19	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Widespread	Potential for minimal harm
2002-03-01	2002-04-01	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Widespread	Minimal harm or potential for actual harm
2003-01-03	2003-02-24	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2003-12-11	2004-02-05	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2003-12-11	2004-02-05	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Isolated	Minimal harm or potential for actual harm

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