| Total Number of Beds: 120 | Percent of Occupied Beds: 99% |
| Total Number of Residents: 119 | Located Within a Hospital: No |
| Type of Ownership: Non profit - Corporation | Multiple Nursing Homes by Same Owner: No |
| Councils the Nursing Home Participates in: Family & Resident | Medicare/Medicaid: Participating in Medicare and Medicaid |
| * Details Last Reported on: 08/07/2003 |
| Date of Violation |
Date Corrected |
Type of Violation |
Deficiency |
Scope |
Level of Harm |
| 2001-05-25 |
2001-07-17 |
Resident Assessment Deficiencies |
Do a new assessment after any major change in a resident's physical or mental health. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-05-25 |
2001-07-17 |
Resident Assessment Deficiencies |
Check and update (if needed) each resident's assessment every 3 months. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-05-25 |
2001-07-17 |
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 |
| 2001-05-25 |
2001-07-17 |
Pharmacy Service Deficiencies |
1) Make sure that residents who take drugs are not given too many doses or for too long; 2) make sure that the use of drugs is carefully watched; or 3) stop or change drugs that cause unwanted effects. |
Isolated |
Minimal harm or potential for actual harm |
| 2001-05-25 |
2001-07-17 |
Nutrition and Dietary Deficiencies |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Potential for minimal harm |
| 2002-06-28 |
2002-08-13 |
Resident Assessment Deficiencies |
Check and update (if needed) each resident's assessment every 3 months. |
Isolated |
Minimal harm or potential for actual harm |
| 2002-06-28 |
2002-08-13 |
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 |
| 2003-08-07 |
2003-09-25 |
Resident Rights Deficiencies |
Keep each resident's personal and medical records private and confidential. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-08-07 |
2003-09-25 |
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 |
| 2003-08-07 |
2003-09-25 |
Quality Care Deficiencies |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-08-07 |
2003-09-25 |
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 |
| 2003-08-07 |
2003-09-25 |
Environmental Deficiencies |
Make sure that staff members wash their hands when needed. |
Isolated |
Minimal harm or potential for actual harm |
| 2003-08-07 |
2003-09-25 |
Environmental Deficiencies |
Have enough outside airflow. |
Widespread |
Potential for minimal harm |
*** All violations listed are based on federal government records.