Evergreen Shelton Health & Rehab

Total Number of Beds: 62	Percent of Occupied Beds: 90%
Total Number of Residents: 56	Located Within a Hospital: No
Type of Ownership: For profit - Individual	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 05/09/2003

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: 16%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 41%
Percent of Residents Who Have Moderate to Severe Pain: 15%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 11%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 6%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 11%
Percent of Residents Who are More Depressed or Anxious: 22%
Percent of Short-Stay Residents With Delirium: 5%
Percent of Residents Who Were Physically Restrained: 8%
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: 13%
Percent of Residents With a Urinary Tract Infection: 16%
** Details Last Reported on: 5/9/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-08-17	2001-09-19	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
2001-08-17	2001-09-19	Quality Care Deficiencies	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Isolated	Minimal harm or potential for actual harm
2001-08-17	2001-09-19	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
2001-08-17	2001-09-19	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Pattern	Potential for minimal harm
2002-09-06	2002-11-19	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
2002-09-06	2002-11-19	Resident Rights Deficiencies	Allow married couples to share a room.	Isolated	Actual harm
2002-09-06	2002-11-19	Resident Rights Deficiencies	Let residents give themselves their drugs if they are able.	Isolated	Minimal harm or potential for actual harm
2002-09-06	2002-12-05	Mistreatment Deficiencies	Protect each resident from all abuse, physical punishment, and being separated from others.	Isolated	Actual harm
2002-09-06	2002-12-31	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
2002-09-06	2002-11-19	Resident Rights Deficiencies	Give enough notice to the resident before changing the resident's room or roommate.	Isolated	Minimal harm or potential for actual harm
2002-09-06	2002-11-19	Quality Care Deficiencies	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Pattern	Minimal harm or potential for actual harm
2002-09-06	2002-11-19	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
2002-09-06	2002-12-31	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2002-09-06	2002-12-31	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Actual harm
2002-09-06	2002-11-19	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2002-09-06	2002-11-19	Quality Care Deficiencies	Make sure that residents with loss of bladder control receive treatment or service to prevent infections and help get normal bladder control.	Isolated	Actual harm
2002-09-06	2002-11-19	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Actual harm
2002-09-06	2002-11-19	Quality Care Deficiencies	Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	Isolated	Actual harm
2002-09-06	2002-11-19	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
2003-05-09	2003-06-30	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.	Pattern	Minimal harm or potential for actual harm
2003-05-09	2003-06-30	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
2003-05-09	2003-06-30	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
2003-05-09	2003-06-30	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
2003-05-09	2003-06-30	Quality Care Deficiencies	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Isolated	Minimal harm or potential for actual harm
2003-05-09	2003-06-30	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2003-05-09	2003-06-30	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Minimal harm or potential for actual harm
2003-05-09	2003-06-30	Quality Care Deficiencies	Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	Isolated	Minimal harm or potential for actual harm
2003-05-09	2003-06-30	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
2003-05-09	2003-06-30	Nutrition and Dietary Deficiencies	1) Provide 3 meals daily at regular times; or 2) serve breakfast within 14 hours after dinner; or 3) offer a snack at bedtime each day.	Pattern	Minimal harm or potential for actual harm
2003-05-09	2003-06-30	Quality Care Deficiencies	Give or get special rehabilitation if in the patient's plan of care.	Isolated	Minimal harm or potential for actual harm

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