General Information: CLAYCO CARE CENTER
Nursing home name CLAYCO CARE CENTER
Address600 FIFTH STREET SOUTHEAST, BOX 129
BARNESVILLE, MN 56514
Phone number (218) 354-2254
Located within a hospital No
Type of ownership For profit - Corporation
Owner operates multiple homesYes
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityNo
Resident and family councils Resident
Certified number of beds 35
Total number of residents 22
Perc of occupied beds 62
Sprinkler status Yes
Number of Facility Reported Incidents0
Number of Substantiated Complaints0
Number of Fines0
Total Amount of Fines$0
Total Number of Penalties0
Total Number of Penalties0
Ratings Summary: CLAYCO CARE CENTER
Overall rating 2
2
Nursing Home Staffing 4
4
Registered Nurses only 4
4
Health Inspections 1
1
Quality Measures 4
4
Nursing Home Staffing Info: CLAYCO CARE CENTER
National AverageMinnesota AverageCLAYCO CARE CENTER
Overall staff rating NA NA 4
4
Registered Nurses only rating NANA 4
4
Total Number of Residents NA NA 22
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 4.05 hours 4.04 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.6 hours 1.6 hours
Registered Nurses Hours per Residents per Day 0.81 hours 0.85 hours 0.59 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.75 hours 1.01 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.44 hours 2.44 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.09 hours 0.07 hours
Health Survey: CLAYCO CARE CENTER
Heath Survey Summary on 2013-12-18
Total Number of Health Deficiencies 5
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Heath Survey Summary on 2012-10-04
Total Number of Health Deficiencies 8
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Heath Survey Summary on 2012-01-13
Total Number of Health Deficiencies 26
Scope and Severity of most Severe Health Deficiency Isolated/Actual harm
Health Survey Details: CLAYCO CARE CENTER
Inspection Results: 12/18/2013
Corrected Deficiency Scope and Severity
01/24/2014 Allow residents to easily view the results of the nursing home's most recent inspection. Widespread/Potential for minimal harm
01/24/2014 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Minimal harm or potential for actual harm
01/27/2014 Store, cook, and serve food in a safe and clean way. Pattern/Minimal harm or potential for actual harm
01/27/2014 At least once a month, have a licensed pharmacist review each resident's medication(s) and report any irregularities to the attending doctor. Isolated/Minimal harm or potential for actual harm
01/27/2014 Have a program that investigates, controls and keeps infection from spreading. Widespread /Minimal harm or potential for actual harm
Inspection Results: 10/04/2012
Corrected Deficiency Scope and Severity
11/16/2012 Allow residents to self-administer drugs if determined safe. Isolated/Minimal harm or potential for actual harm
11/16/2012 Give residents a notice of rights, rules, services and charges. Widespread/Potential for minimal harm
11/16/2012 Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. Pattern/Minimal harm or potential for actual harm
11/16/2012 Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Isolated/Minimal harm or potential for actual harm
11/16/2012 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Isolated/Minimal harm or potential for actual harm
11/16/2012 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Minimal harm or potential for actual harm
11/16/2012 At least once a month, have a licensed pharmacist review each resident's medication(s) and report any irregularities to the attending doctor. Isolated/Minimal harm or potential for actual harm
11/16/2012 Have a program that investigates, controls and keeps infection from spreading. Widespread /Minimal harm or potential for actual harm
Inspection Results: 01/13/2012
Corrected Deficiency Scope and Severity
03/09/2012 Conduct initial and periodic assessments of each resident's functional capacity. Pattern/Minimal harm or potential for actual harm
03/09/2012 Provide proper discharge planning and communication, of the resident's health status and summary of the resident's nursing home stay. Pattern/Minimal harm or potential for actual harm
07/12/2012 Provide care by qualified persons according to each resident's written plan of care. Isolated/Minimal harm or potential for actual harm
07/03/2012 Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Pattern/Minimal harm or potential for actual harm
03/09/2012 Assure that each residents assessment is updated at least once every 3 months. Isolated/Minimal harm or potential for actual harm
05/10/2012 Review or revise the resident's care plan after any major change in physical or mental health. Pattern/Minimal harm or potential for actual harm
03/09/2012 Provide necessary care and services to maintain or improve the highest well being of each resident . Pattern/Minimal harm or potential for actual harm
03/09/2012 Provide housekeeping and maintenance services. Pattern/Minimal harm or potential for actual harm
03/09/2012 Provide activities to meet the interests and needs of each resident. Isolated/Minimal harm or potential for actual harm
05/10/2012 Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. Widespread/Potential for minimal harm
05/10/2012 1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. Isolated/Minimal harm or potential for actual harm
03/09/2012 Keep each resident free from physical restraints, unless needed for medical treatment. Isolated/Minimal harm or potential for actual harm
03/09/2012 Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Isolated/Minimal harm or potential for actual harm
03/09/2012 Assist those residents who need help with eating/drinking, grooming and personal and oral hygiene. Isolated/Minimal harm or potential for actual harm
07/12/2012 Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. Isolated/Minimal harm or potential for actual harm
05/10/2012 Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions. Isolated/Minimal harm or potential for actual harm
07/12/2012 Ensure that residents with limited range of motion receive appropriate treatment and services to increase range of motion or prevent further decrease in range of motion. Pattern/Minimal harm or potential for actual harm
07/03/2012 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Isolated/Actual harm
03/09/2012 Ensure residents maintain acceptable nutritional status. Pattern/Minimal harm or potential for actual harm
03/09/2012 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Minimal harm or potential for actual harm
03/09/2012 Develop policies and procedures for influenza and pneumococcal immunizations. Isolated/Minimal harm or potential for actual harm
07/12/2012 Have enough nurses to care for every resident in a way that maximizes the resident's well being. Pattern/Minimal harm or potential for actual harm
03/09/2012 Post nurse staffing information/data on a daily basis. Widespread/Potential for minimal harm
03/09/2012 Have a program that investigates, controls and keeps infection from spreading. Isolated/Minimal harm or potential for actual harm
03/09/2012 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Pattern/Minimal harm or potential for actual harm
07/03/2012 Set up an ongoing quality assessment and assurance group to review quality deficiencies quarterly, and develop corrective plans of action. Widespread /Minimal harm or potential for actual harm

Fire Safety Survey: CLAYCO CARE CENTER
Fire Safety Survey Summary on 2013-12-18
Total Number of Fire SafetyDeficiencies 0
Scope and Severity of most Severe Health Deficiency
Fire Safety Survey Summary on 2012-10-03
Total Number of Fire SafetyDeficiencies 2
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2012-01-12
Total Number of Fire SafetyDeficiencies 3
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey: CLAYCO CARE CENTER
Fire Safety Survey Results: 10/03/2012
Corrected Deficiency Severity
11/15/2012 Record of quarterly fire drills for each shift under varying conditions. Widespread /Minimal harm or potential for actual harm
11/19/2012 Other fire safety features required by fire safety codes. Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Results: 01/12/2012
Corrected Deficiency Severity
01/13/2012 Walls that prevent smoke from passing through and would resist fire for at least one hour. Pattern/Minimal harm or potential for actual harm
01/16/2012 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Widespread /Minimal harm or potential for actual harm
01/30/2012 An approved automatic sprinkler system connected to the fire alarm system. Widespread/Potential for minimal harm

Resident Complaints: CLAYCO CARE CENTER
Not available

Quality Measures: CLAYCO CARE CENTER
Quality Measures National Average Minnesota Average CLAYCO CARE CENTER
Overall quality rating NA NA 4
4
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 14.0% 17.4%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 10.5% 7.5%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 4.0% 7.7%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 7.1% 0.0%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 47.3% 40.6%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 3.4% 0.0%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 4.9% 6.9%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 6.2% 9.1%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 0.7% 0.0%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 3.9% 6.8%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 94.0% 98.3%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 95.7% 100.0%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 16.4% 25.0%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 24.2% 12.2%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 1.0% 0.0%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 84.4% 100.0%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 84.1% 86.3%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 1.9% 4.2%

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