Beverly Healthcare - Black Hills

Total Number of Beds: 70	Percent of Occupied Beds: 91%
Total Number of Residents: 64	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: 11/20/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.59

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.43

Number of CNA Hours per Nursing Home Resident per Day: 1.9

Number of Staff Hours per Nursing Home Resident per Day: 2.92

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 13%
Percent of High-Risk Residents Who Have Pressure Sores: 15%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 42%
Percent of Residents Who Have Moderate to Severe Pain: 10%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 11%
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: 26%
Percent of Residents Who are More Depressed or Anxious: 24%
Percent of Short-Stay Residents With Delirium: 2%
Percent of Residents Who Were Physically Restrained: 2%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 51%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 9%
Percent of Residents With a Urinary Tract Infection: 13%
** Details Last Reported on: 11/20/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-12-05	2002-01-29	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Pattern	Minimal harm or potential for actual harm
2001-12-05	2002-01-29	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
2001-12-05	2002-01-29	Resident Assessment Deficiencies	Make sure that doctors visit residents regularly, as required.	Isolated	Minimal harm or potential for actual harm
2002-12-11	2003-02-24	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2002-12-11	2003-02-24	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2003-11-20	2004-01-16	Resident Rights Deficiencies	Tell each resident who can get Medicaid benefits about 1) which items and services Medicaid covers and which the resident must pay for; or 2) how to apply for Medicaid, along with the names and addresses of State groups that can help.	Widespread	Potential for minimal harm
2003-11-20	2004-01-16	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Isolated	Minimal harm or potential for actual harm
2003-11-20	2004-01-16	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.	Isolated	Minimal harm or potential for actual harm
2003-11-20	2004-01-16	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2003-11-20	2004-01-16	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
2003-11-20	2004-01-16	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Widespread	Potential for minimal harm
2003-11-20	2004-01-16	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm

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