| Total Number of Beds: 163 | Percent of Occupied Beds: 97% |
| Total Number of Residents: 158 | Located Within a Hospital: No |
| Type of Ownership: Non profit - Corporation | Multiple Nursing Homes by Same Owner: No |
| Councils the Nursing Home Participates in: Family & Resident | Medicare/Medicaid: Participating in Medicare and Medicaid |
| * Details Last Reported on: 11/20/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-08-09 |
2001-09-13 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| 2001-08-09 |
2001-09-13 |
Pharmacy Service Deficiencies |
Properly mark drugs and other similar products. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-09-19 |
2002-10-25 |
Resident Assessment Deficiencies |
Do a new assessment after any major change in a resident's physical or mental health. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-09-19 |
2002-10-25 |
Quality Care Deficiencies |
Give professional services that meet a professional standard of quality. |
Pattern |
Minimal harm or potential for actual harm |
| 2002-09-19 |
2002-10-25 |
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 |
| 2002-09-19 |
2002-10-25 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| 2002-09-19 |
2002-10-25 |
Pharmacy Service Deficiencies |
Properly mark drugs and other similar products. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-09-19 |
2002-10-25 |
Administration Deficiencies |
Keep accurate and appropriate medical records. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-11-20 |
2003-12-22 |
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 |
| 2003-11-20 |
2003-12-22 |
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 |
| 2003-11-20 |
2003-12-22 |
Quality Care Deficiencies |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-11-20 |
2003-12-22 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.