St Lukes Northland Hospital Skilled Nursing Facility

Total Number of Beds: 11	Percent of Occupied Beds: 64%
Total Number of Residents: 7	Located Within a Hospital: Yes
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 04/09/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 2.1

Number of LPN/LVN Hours per Nursing Home Resident per Day: 1.81

Number of CNA Hours per Nursing Home Resident per Day: 1.81

Number of Staff Hours per Nursing Home Resident per Day: 5.72

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 30%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 52%
Percent of Short-Stay Residents With Delirium: 0%
** Details Last Reported on: 4/9/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-06-13	2001-08-28	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2001-06-13	2001-08-28	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Minimal harm or potential for actual harm
2001-06-13	2001-08-28	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Widespread	Potential for minimal harm
2001-06-13	2001-08-28	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2003-04-09	0000-00-00	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm

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