| Total Number of Beds: 110 | Percent of Occupied Beds: 95% |
| Total Number of Residents: 104 | Located Within a Hospital: No |
| Type of Ownership: Non profit - Church related | Multiple Nursing Homes by Same Owner: Yes |
| Councils the Nursing Home Participates in: None | Medicare/Medicaid: Participating in Medicare and Medicaid |
| * Details Last Reported on: 09/30/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-08-13 |
2001-09-21 |
Resident Rights Deficiencies |
Keep each resident's personal and medical records private and confidential. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-08-13 |
2001-09-21 |
Quality Care Deficiencies |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-08-13 |
2001-09-21 |
Quality Care Deficiencies |
Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-08-13 |
2001-09-21 |
Environmental Deficiencies |
Be designed, built, equipped, or well kept to protect the health and safety of residents, workers, and the public. |
Pattern |
Minimal harm or potential for actual harm |
| 2003-09-30 |
2003-10-30 |
Quality Care Deficiencies |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-09-30 |
2003-10-30 |
Resident Assessment Deficiencies |
Keep assessments completed in the preceding 15 months in the resident's active record. |
Pattern |
Potential for minimal harm |
| 2003-09-30 |
2003-10-30 |
Quality Care Deficiencies |
Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion. |
Pattern |
Minimal harm or potential for actual harm |
| 2003-09-30 |
2003-10-30 |
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 |
| 2003-09-30 |
2003-10-30 |
Nutrition and Dietary Deficiencies |
Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. |
Pattern |
Minimal harm or potential for actual harm |
| 2003-09-30 |
2003-10-30 |
Environmental Deficiencies |
Make sure that the nursing home area is safe, easy to use, clean and comfortable. |
Pattern |
Potential for minimal harm |
*** All violations listed are based on federal government records.