Holly Hill Manor Inc.

Total Number of Beds: 55	Percent of Occupied Beds: 85%
Total Number of Residents: 47	Located Within a Hospital: No
Type of Ownership: For 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: 09/15/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.77

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.3

Number of CNA Hours per Nursing Home Resident per Day: 2.24

Number of Staff Hours per Nursing Home Resident per Day: 3.31

Nursing Home Resident Information**:

Percent of Residents Who Have Moderate to Severe Pain: 2%
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: 8%
Percent of Residents Who are More Depressed or Anxious: 3%
Percent of Residents Who Were Physically Restrained: 0%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 0%
Percent of Residents With a Urinary Tract Infection: 10%
** Details Last Reported on: 9/15/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-07-11	2001-07-31	Environmental Deficiencies	Provide rooms that are big enough for each resident.	Pattern	Potential for minimal harm
2002-08-06	0000-00-00	Environmental Deficiencies	Provide rooms that are big enough for each resident.	Pattern	Potential for minimal harm
2003-09-15	2003-11-03	Mistreatment Deficiencies	1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents.	Pattern	Minimal harm or potential for actual harm
2003-09-15	2003-11-03	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
2003-09-15	2003-11-01	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm

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