| Total Number of Beds: 120 | Percent of Occupied Beds: 93% |
| Total Number of Residents: 111 | Located Within a Hospital: No |
| Type of Ownership: Non profit - Corporation | 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: 10/20/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-10-17 |
2001-11-26 |
Resident Rights Deficiencies |
Keep each resident's personal and medical records private and confidential. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-10-17 |
2001-11-26 |
Resident Rights Deficiencies |
Let residents give themselves their drugs if they are able. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-10-17 |
2001-11-26 |
Resident Rights Deficiencies |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Pattern |
Minimal harm or potential for actual harm |
| 2001-10-17 |
2001-11-26 |
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 |
| 2001-10-17 |
2001-11-26 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Pattern |
Minimal harm or potential for actual harm |
| 2001-10-17 |
2001-11-26 |
Environmental Deficiencies |
Have a program to keep infection from spreading. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-08-22 |
2002-10-03 |
Environmental Deficiencies |
Keep safe, clean and homelike surroundings. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-08-22 |
2002-10-03 |
Pharmacy Service Deficiencies |
Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-08-22 |
2002-10-03 |
Nutrition and Dietary Deficiencies |
Make sure that the attending doctor orders special diets. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-08-22 |
2002-10-03 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-08-22 |
2002-10-03 |
Pharmacy Service Deficiencies |
Keep drugs and other similar products locked safely and properly stored. |
Isolated |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.