Mount Miguel Covenant Village

Total Number of Beds: 90	Percent of Occupied Beds: 82%
Total Number of Residents: 74	Located Within a Hospital: No
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 10/14/2003

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 High-Risk Residents Who Have Pressure Sores: 13%
Percent of Residents Who Have Moderate to Severe Pain: 1%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 19%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 0%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 18%
Percent of Residents Who are More Depressed or Anxious: 21%
Percent of Residents Who Were Physically Restrained: 11%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 70%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 5%
Percent of Residents With a Urinary Tract Infection: 2%
** Details Last Reported on: 10/14/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-10-15	2001-11-08	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2002-10-24	2002-11-13	Resident Rights Deficiencies	Bill properly: Charged resident for items that Medicare or Medicaid pays for.	Pattern	Potential for minimal harm
2002-10-24	2002-11-21	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
2002-10-24	2002-11-21	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.	Pattern	Potential for minimal harm
2002-10-24	2002-11-19	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2002-10-24	2002-11-21	Quality Care Deficiencies	Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.	Isolated	Minimal harm or potential for actual harm
2002-10-24	2002-11-22	Administration Deficiencies	Have a detailed, written plan for disasters and emergencies.	Widespread	Potential for minimal harm
2003-10-14	2003-11-11	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
2003-10-14	2003-11-11	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
2003-10-14	2003-11-13	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
2003-10-14	2003-11-07	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
2003-10-14	2003-11-13	Resident Assessment Deficiencies	1) Develop a complete care plan within 7 days of each resident's admission; 2) prepare a care plan with the care team, including the primary nurse, doctor, resident or resident's family or representative; or 3) check and update the care plan.	Isolated	Minimal harm or potential for actual harm
2003-10-14	2003-11-12	Quality Care Deficiencies	Give professional services that follow each resident's written care plan.	Isolated	Minimal harm or potential for actual harm
2003-10-14	2003-11-12	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	Minimal harm or potential for actual harm
2003-10-14	2003-11-12	Quality Care Deficiencies	Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion.	Isolated	Minimal harm or potential for actual harm
2003-10-14	2003-11-05	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Pattern	Potential for minimal harm
2003-10-14	2003-11-05	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
2003-10-14	2003-11-13	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm

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