Waukon Good Samaritan Center

Total Number of Beds: 90	Percent of Occupied Beds: 94%
Total Number of Residents: 85	Located Within a Hospital: No
Type of Ownership: Non profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 11/07/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.41

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.55

Number of CNA Hours per Nursing Home Resident per Day: 2.37

Number of Staff Hours per Nursing Home Resident per Day: 3.33

Nursing Home Resident Information**:

Percent of Low-Risk Residents Who Have Pressure Sores: 4%
Percent of High-Risk Residents Who Have Pressure Sores: 8%
Percent of Residents Who Have Moderate to Severe Pain: 10%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 16%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 1%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 17%
Percent of Residents Who are More Depressed or Anxious: 25%
Percent of Residents Who Were Physically Restrained: 5%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 38%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 3%
Percent of Residents With a Urinary Tract Infection: 0%
** Details Last Reported on: 11/7/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-09-21	2001-10-21	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
2001-09-21	2001-10-21	Quality Care Deficiencies	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Isolated	Minimal harm or potential for actual harm
2001-09-21	2001-10-21	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2001-09-21	2001-10-21	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Minimal harm or potential for actual harm
2003-11-07	2003-11-19	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
2003-11-07	2003-11-19	Administration Deficiencies	Follow all laws and professional standards.	Pattern	Minimal harm or potential for actual harm

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