Forest Park Hospital

Total Number of Beds: 19	Percent of Occupied Beds: 95%
Total Number of Residents: 18	Located Within a Hospital: Yes
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 05/20/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 2.89

Number of LPN/LVN Hours per Nursing Home Resident per Day: 1.02

Number of CNA Hours per Nursing Home Resident per Day: 2.68

Number of Staff Hours per Nursing Home Resident per Day: 6.59

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 33%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 30%
Percent of Short-Stay Residents With Delirium: 2%
** Details Last Reported on: 5/20/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-10-26	2001-12-13	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Widespread	Potential for minimal harm
2001-10-26	2001-12-13	Quality Care Deficiencies	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Isolated	Minimal harm or potential for actual harm
2001-10-26	2001-12-13	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Widespread	Potential for minimal harm
2001-10-26	2001-12-13	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Pattern	Actual harm
2001-10-26	2001-12-13	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Pattern	Actual harm
2001-10-26	2001-12-13	Resident Assessment Deficiencies	Electronically record and report resident status assessments in a timely manner as required in order to monitor resident health and progress.	Widespread	Potential for minimal harm
2001-10-26	2001-12-13	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Pattern	Immediate jeopardy to resident health or safety
2001-10-26	2001-12-13	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Pattern	Immediate jeopardy to resident health or safety
2001-10-26	2001-12-13	Quality Care Deficiencies	Have enough nurses to care for every resident in a way that maximizes the resident's well being.	Pattern	Actual harm
2001-10-26	2001-12-13	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Widespread	Potential for minimal harm
2001-10-26	2001-12-13	Environmental Deficiencies	Keep a resident apart from the others if the resident has an infection that can spread.	Pattern	Actual harm
2001-10-26	2001-12-13	Administration Deficiencies	Be administered in a way that leads to the highest possible level of well being for each resident.	Pattern	Immediate jeopardy to resident health or safety
2002-05-15	2002-07-25	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Minimal harm or potential for actual harm
2002-05-15	2002-07-25	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
2002-05-15	2002-07-25	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Pattern	Minimal harm or potential for actual harm
2002-05-15	2002-07-25	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2003-05-20	2003-06-30	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Pattern	Minimal harm or potential for actual harm
2003-05-20	2003-06-30	Pharmacy Service Deficiencies	Make sure that residents are safe from serious medication errors.	Pattern	Minimal harm or potential for actual harm
2003-05-20	2003-06-30	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Isolated	Minimal harm or potential for actual harm
2003-05-20	2003-06-30	Administration Deficiencies	Hold committee meetings every 3 months to review and ensure quality in the nursing home.	Pattern	Minimal harm or potential for actual harm

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