Polly Ryon Hospital Authority

Total Number of Beds: 36	Percent of Occupied Beds: 39%
Total Number of Residents: 14	Located Within a Hospital: Yes
Type of Ownership: Government - Hospital district	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 10/08/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 1.8

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.98

Number of CNA Hours per Nursing Home Resident per Day: 2.95

Number of Staff Hours per Nursing Home Resident per Day: 5.73

Nursing Home Resident Information**:

** Details Last Reported on: 10/8/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-10-31	2001-12-15	Resident Assessment Deficiencies	Do a new assessment after any major change in a resident's physical or mental health.	Isolated	Minimal harm or potential for actual harm
2001-10-31	2001-12-15	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	Minimal harm or potential for actual harm
2001-10-31	2001-12-15	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Isolated	Minimal harm or potential for actual harm
2001-10-31	2002-01-21	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
2001-10-31	2001-12-20	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2003-10-08	2003-10-30	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2003-10-08	2003-11-06	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Actual harm
2003-10-08	2003-11-06	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.	Pattern	Minimal harm or potential for actual harm
2003-10-08	2003-10-23	Administration Deficiencies	Set up or keep a group of people to review and ensure quality.	Widespread	Minimal harm or potential for actual harm

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