The Hospital Skilled Nursing Facility

Total Number of Beds: 40	Percent of Occupied Beds: 100%
Total Number of Residents: 40	Located Within a Hospital: Yes
Type of Ownership: Government - City	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: 11/20/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.53

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.81

Number of CNA Hours per Nursing Home Resident per Day: 2.11

Number of Staff Hours per Nursing Home Resident per Day: 3.45

Nursing Home Resident Information**:

Percent of High-Risk Residents Who Have Pressure Sores: 20%
Percent of Residents Who Have Moderate to Severe Pain: 4%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 3%
Percent of Residents Who are More Depressed or Anxious: 16%
Percent of Residents Who Were Physically Restrained: 16%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 5%
Percent of Residents With a Urinary Tract Infection: 8%
** Details Last Reported on: 11/20/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-01-17	2002-02-12	Resident Rights Deficiencies	Properly hold, secure and manage each resident's personal money which is deposited with the nursing home.	Pattern	Potential for minimal harm
2002-01-17	2002-03-15	Resident Assessment Deficiencies	Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing.	Pattern	Minimal harm or potential for actual harm
2002-11-20	2003-01-07	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
2002-11-20	2003-01-07	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
2002-11-20	2003-01-07	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
2002-11-20	2003-01-07	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
2003-11-20	2003-12-31	Resident Rights Deficiencies	Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged.	Isolated	Minimal harm or potential for actual harm
2003-11-20	2003-12-31	Mistreatment Deficiencies	Protect each resident from all abuse, physical punishment, and being separated from others.	Isolated	Minimal harm or potential for actual harm
2003-11-20	2003-12-31	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
2003-11-20	2003-12-31	Quality Care Deficiencies	Make sure that each residents' abilities to take care of themselves does not lessen, unless a change cannot be avoided.	Isolated	Minimal harm or potential for actual harm
2003-11-20	2003-12-31	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm

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