O'Connor Hospital D/P Skilled Nursing Facility

Total Number of Beds: 24	Percent of Occupied Beds: 58%
Total Number of Residents: 14	Located Within a Hospital: Yes
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 02/05/2003

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**:

Percent of Short-Stay Residents With Pressure Sores: 30%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 29%
Percent of Short-Stay Residents With Delirium: 4%
** Details Last Reported on: 2/5/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2000-11-20	2001-01-04	Resident Rights Deficiencies	1) Protect current or future residents from giving up their Medicaid or Medicare benefits; or 2) follow federal rules for admissions.	Pattern	Potential for minimal harm
2000-11-20	2001-01-04	Mistreatment Deficiencies	Protect residents from mistreatment, neglect, and/or theft of personal property.	Pattern	Potential for minimal harm
2000-11-20	2001-01-04	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Widespread	Potential for minimal harm
2000-11-20	2001-01-04	Administration Deficiencies	Give or get lab tests to meet the needs of residents.	Isolated	Minimal harm or potential for actual harm
2000-11-20	2001-01-04	Administration Deficiencies	Train all employees on what to do in an emergency.	Pattern	Potential for minimal harm
2002-01-24	2002-02-15	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Pattern	Minimal harm or potential for actual harm
2002-01-24	2002-02-15	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Isolated	Minimal harm or potential for actual harm
2002-01-24	2002-02-15	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Minimal harm or potential for actual harm
2002-01-24	2002-02-15	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
2002-01-24	2002-02-15	Environmental Deficiencies	Get rid of garbage properly.	Isolated	Minimal harm or potential for actual harm
2002-01-24	2002-02-15	Administration Deficiencies	Get proof that a nurse aide has the training and skills that the State requires.	Isolated	Minimal harm or potential for actual harm
2002-01-24	2002-02-15	Administration Deficiencies	Give or get lab tests to meet the needs of residents.	Isolated	Minimal harm or potential for actual harm
2002-01-24	2002-02-15	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
2003-02-05	2003-03-31	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
2003-02-05	2003-03-31	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
2003-02-05	2003-03-31	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Minimal harm or potential for actual harm
2003-02-05	2003-03-31	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Isolated	Minimal harm or potential for actual harm
2003-02-05	2003-03-31	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2003-02-05	2003-03-31	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm
2003-02-05	2003-03-31	Administration Deficiencies	Train all employees on what to do in an emergency.	Isolated	Minimal harm or potential for actual harm

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