Simi Valley Hospital & Health

Total Number of Beds: 44	Percent of Occupied Beds: 32%
Total Number of Residents: 14	Located Within a Hospital: Yes
Type of Ownership: Non profit - Church related	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 09/04/2003

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: 23%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 29%
Percent of Short-Stay Residents With Delirium: 0%
** Details Last Reported on: 9/4/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-07-02	2001-07-25	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Pattern	Potential for minimal harm
2001-07-02	2001-07-25	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Widespread	Potential for minimal harm
2001-07-02	2001-07-25	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
2001-07-02	2001-07-25	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2001-07-02	2001-07-25	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Isolated	Minimal harm or potential for actual harm
2002-07-17	2002-08-26	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
2002-07-17	2002-08-26	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Potential for minimal harm
2002-07-17	2002-07-17	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Widespread	Potential for minimal harm
2002-07-17	2002-07-17	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Widespread	Minimal harm or potential for actual harm
2002-07-17	2002-08-26	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Widespread	Potential for minimal harm
2003-09-04	2003-10-15	Pharmacy Service Deficiencies	Act when the pharmacist reports something unusual.	Isolated	Minimal harm or potential for actual harm
2003-09-04	2003-09-04	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Potential for minimal harm

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