| Total Number of Beds: 121 | Percent of Occupied Beds: 96% |
| Total Number of Residents: 116 | Located Within a Hospital: No |
| Type of Ownership: Non profit - Church related | 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: 05/09/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-05-04 |
2001-06-07 |
Quality Care Deficiencies |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-05-04 |
2001-06-07 |
Environmental Deficiencies |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-05-04 |
2001-06-07 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-04-04 |
2002-04-18 |
Resident Assessment Deficiencies |
1) Develop a complete care plan within 7 days of each resident's admission; 2) prepare a care plan with the care team, including the primary nurse, doctor, resident or resident's family or representative; or 3) check and update the care plan. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-04-04 |
2002-04-18 |
Quality Care Deficiencies |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-04-04 |
2002-04-18 |
Quality Care Deficiencies |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Actual harm |
| 2002-04-04 |
2002-04-18 |
Administration Deficiencies |
Choose a doctor to be the medical director. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-05-09 |
2003-06-18 |
Quality Care Deficiencies |
Give each resident care and services to get or keep the highest quality of life possible. |
Isolated |
Actual harm |
| 2003-05-09 |
2003-06-09 |
Quality Care Deficiencies |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Actual harm |
| 2003-05-09 |
2003-06-06 |
Quality Care Deficiencies |
Make sure that each resident's nutritional needs were met. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-05-09 |
2003-06-06 |
Administration Deficiencies |
Choose a doctor to be the medical director. |
Isolated |
Minimal harm or potential for actual harm |
*** All violations listed are based on federal government records.