Rest Haven Health Care Center

Total Number of Beds: 21	Percent of Occupied Beds: 90%
Total Number of Residents: 19	Located Within a Hospital: No
Type of Ownership: For profit - Individual	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: 10/07/2003

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**:

** Details Last Reported on: 10/7/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2002-09-09	0000-00-00	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Potential for minimal harm
2003-10-07	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
2003-10-07	2003-11-07	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.