| Total Number of Beds: 120 | Percent of Occupied Beds: 96% |
| Total Number of Residents: 115 | Located Within a Hospital: No |
| Type of Ownership: Non profit - Corporation | Multiple Nursing Homes by Same Owner: No |
| Councils the Nursing Home Participates in: Resident | Medicare/Medicaid: Participating in Medicare and Medicaid |
| * Details Last Reported on: 09/12/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-09-28 |
2001-11-28 |
Pharmacy Service Deficiencies |
Properly mark drugs and other similar products. |
Pattern |
Minimal harm or potential for actual harm |
| 2001-09-28 |
2001-11-28 |
Environmental Deficiencies |
Keep all essential equipment working safely. |
Pattern |
Minimal harm or potential for actual harm |
| 2001-09-28 |
2001-11-28 |
Administration Deficiencies |
Follow all laws and professional standards. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-08-29 |
2002-10-27 |
Resident Assessment Deficiencies |
Make a complete assessment that covers all questions for areas that are listed in official regulations. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-08-29 |
2002-10-27 |
Nutrition and Dietary Deficiencies |
Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. |
Widespread |
Minimal harm or potential for actual harm |
| 2002-08-29 |
2002-10-27 |
Administration Deficiencies |
Keep accurate and appropriate medical records. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-09-12 |
2003-10-15 |
Resident Rights Deficiencies |
Tell each resident who can get Medicaid benefits about 1) which items and services Medicaid covers and which the resident must pay for; or 2) how to apply for Medicaid, along with the names and addresses of State groups that can help. |
Widespread |
Potential for minimal harm |
| 2003-09-12 |
2003-10-31 |
Resident Rights Deficiencies |
Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-09-12 |
2003-10-31 |
Mistreatment Deficiencies |
Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property. |
Pattern |
Minimal harm or potential for actual harm |
| 2003-09-12 |
2003-10-15 |
Quality Care Deficiencies |
Give each resident care and services to get or keep the highest quality of life possible. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-09-12 |
2003-10-31 |
Quality Care Deficiencies |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.