River Region Health System Skilled Nursing Facility

Total Number of Beds: 11	Percent of Occupied Beds: 91%
Total Number of Residents: 10	Located Within a Hospital: Yes
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 09/19/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 3.89

Number of LPN/LVN Hours per Nursing Home Resident per Day: 2.16

Number of CNA Hours per Nursing Home Resident per Day: 2

Number of Staff Hours per Nursing Home Resident per Day: 8.05

Nursing Home Resident Information**:

** Details Last Reported on: 9/19/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-10-04	2001-10-12	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2003-09-19	2003-09-24	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Widespread	Potential for minimal harm
2003-09-19	2003-09-19	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Immediate jeopardy to resident health or safety
2003-09-19	2003-09-19	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm
2003-09-19	2003-09-19	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.