Bellerose Convalescent Hospital

Total Number of Beds: 39	Percent of Occupied Beds: 97%
Total Number of Residents: 38	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	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: 04/22/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day:

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

Number of CNA Hours per Nursing Home Resident per Day:

Number of Staff Hours per Nursing Home Resident per Day:

Nursing Home Resident Information**:

** Details Last Reported on: 4/22/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2000-12-20	2001-02-03	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Pattern	Potential for minimal harm
2000-12-20	2001-02-03	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
2000-12-20	2001-02-03	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	Potential for minimal harm
2000-12-20	2001-02-03	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
2000-12-20	2001-02-03	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.	Pattern	Potential for minimal harm
2000-12-20	2001-02-03	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
2000-12-20	2001-02-03	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Widespread	Potential for minimal harm
2000-12-20	2001-02-03	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
2002-03-05	2002-03-20	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Isolated	Minimal harm or potential for actual harm
2002-03-05	2002-03-20	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
2002-03-05	2002-03-20	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm
2003-04-22	2003-05-08	Resident Rights Deficiencies	Give the resident's legal representative the same rights as the resident.	Isolated	Minimal harm or potential for actual harm
2003-04-22	2003-05-08	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Pattern	Potential for minimal harm
2003-04-22	2003-05-08	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2003-04-22	2003-05-08	Administration Deficiencies	Train all employees on what to do in an emergency.	Pattern	Potential for minimal harm

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