North Valley Manor, LLC

Total Number of Beds: 94	Percent of Occupied Beds: 56%
Total Number of Residents: 53	Located Within a Hospital: No
Type of Ownership: For profit - Individual	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 01/10/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.54

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.54

Number of CNA Hours per Nursing Home Resident per Day: 2.59

Number of Staff Hours per Nursing Home Resident per Day: 3.67

Nursing Home Resident Information**:

Percent of Low-Risk Residents Who Have Pressure Sores: 5%
Percent of Residents Who Have Moderate to Severe Pain: 6%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 15%
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: 18%
Percent of Residents Who are More Depressed or Anxious: 7%
Percent of Residents Who Were Physically Restrained: 7%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 38%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 3%
Percent of Residents With a Urinary Tract Infection: 5%
** Details Last Reported on: 1/10/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2000-12-21	2001-02-02	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Widespread	Potential for minimal harm
2002-01-28	2002-03-22	Resident Rights Deficiencies	Properly hold, secure and manage each resident's personal money which is deposited with the nursing home.	Isolated	Minimal harm or potential for actual harm
2002-01-28	2002-03-22	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Pattern	Minimal harm or potential for actual harm
2002-01-28	2002-03-22	Quality Care Deficiencies	Use a registered nurse at least 8 hours a day, 7 days a week.	Widespread	Minimal harm or potential for actual harm
2003-01-10	2003-02-14	Resident Rights Deficiencies	Properly hold, secure and manage each resident's personal money which is deposited with the nursing home.	Pattern	Minimal harm or potential for actual harm
2003-01-10	2003-02-14	Resident Rights Deficiencies	Have a private telephone available for use.	Pattern	Potential for minimal harm
2003-01-10	2003-02-14	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Pattern	Minimal harm or potential for actual harm
2003-01-10	2003-02-14	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Pattern	Potential for minimal harm
2003-01-10	2003-02-14	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
2003-01-10	2003-02-14	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Pattern	Minimal harm or potential for actual harm
2003-01-10	2003-02-14	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.	Pattern	Potential for minimal harm
2003-01-10	2003-02-14	Quality Care Deficiencies	Give the right treatment and services to residents who have mental or social problems adjusting.	Isolated	Minimal harm or potential for actual harm
2003-01-10	2003-02-14	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Immediate jeopardy to resident health or safety
2003-01-10	2003-02-14	Quality Care Deficiencies	Give each resident a special diet to help when there is a nutritional problem.	Isolated	Minimal harm or potential for actual harm
2003-01-10	2003-02-14	Environmental Deficiencies	Be designed, built, equipped, or well kept to protect the health and safety of residents, workers, and the public.	Isolated	Minimal harm or potential for actual harm
2003-01-10	2003-02-14	Environmental Deficiencies	Make sure that a working call system is available in each resident's room or bathroom and bathing area.	Widespread	Minimal harm or potential for actual harm

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