| Total Number of Beds: 100 | Percent of Occupied Beds: 100% |
| Total Number of Residents: 100 | Located Within a Hospital: No |
| Type of Ownership: Non profit - Corporation | Multiple Nursing Homes by Same Owner: No |
| Councils the Nursing Home Participates in: Family & Resident | Medicare/Medicaid: Participating in Medicare and Medicaid |
| * Details Last Reported on: 09/18/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-08-17 |
2001-10-05 |
Environmental Deficiencies |
Provide needed housekeeping and maintenance. |
Pattern |
Potential for minimal harm |
| 2001-08-17 |
2001-10-05 |
Environmental Deficiencies |
Make sure that the nursing home area is free of dangers that cause accidents. |
Pattern |
Potential for minimal harm |
| 2001-08-17 |
2001-10-05 |
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. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-08-17 |
2001-10-05 |
Administration Deficiencies |
Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-08-23 |
2002-10-05 |
Resident Rights Deficiencies |
Give the resident's legal representative the same rights as the resident. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-08-23 |
2002-10-05 |
Mistreatment Deficiencies |
1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-08-23 |
2002-10-05 |
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 |
| 2002-08-23 |
2002-10-05 |
Quality Care Deficiencies |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-08-23 |
2002-10-05 |
Quality Care Deficiencies |
Give or get dental care for each resident. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-08-23 |
2002-10-05 |
Pharmacy Service Deficiencies |
Keep drugs and other similar products locked safely and properly stored. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-08-23 |
2002-10-05 |
Administration Deficiencies |
Give or get lab tests by a certified laboratory. |
Pattern |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.