St Nicholas Transitional Care

Total Number of Beds: 15	Percent of Occupied Beds: 47%
Total Number of Residents: 7	Located Within a Hospital: Yes
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 09/05/2003

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**:

** Details Last Reported on: 9/5/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-10-24	2001-11-09	Administration Deficiencies	Follow all laws and professional standards.	Isolated	Minimal harm or potential for actual harm
2002-09-10	0000-00-00	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Widespread	Potential for minimal harm

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