County: Alpine, Amador and Calaveras

City: Jackson

Kit Carson Nursing & Rehabilitation Center
(209) 223-2231 — 811 Court Street — Jackson, CA 95642

Services
How to interpret services information.

Cap.= 199 Type = SNF Medi-Cal: yes Medicare: yes

From CANHR questionnaire returned 9/4/2001:
"Alzheimer's Unit": NoWanderer alert: Yes
Locked Ward: Unk.
Types of Residents Accepted: A D E F I J L O P Q R S T U V
Types of Residents Not Accepted: N
Languages spoken by direct-care staff:
Family Council: Not Specified

Violations Record
From Dept. of Public Health as of 4/30/2008;
Citations as of 5/1/2009.
Last DHS Certification Inspection = 4/18/2008.
How to interpret violations data.
Year Citations Deficiencies Complaints
  AA A B Rec'd Ca. Avg Rec'd Ca. Avg
2003 0 0 0 2 15 10 8.5
2004 0 0 4 30 17.8 13 9.2
2005 0 0 0 38 19.6 9 10.4
2006 0 0 2 8 20.8 30 12.5
2007 0 0 0 29 21.7 6 14.8
2008 0 0 0 21 12.1 1 6.3

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City: Jackson

Sutter Amador Hospital D/P SNF
(209) 223-7500 — 200 Mission Blvd. — Jackson, CA 95642

Services
How to interpret services information.

Cap.= 24 Type = D/P SNF Medi-Cal: Withdrawn Medicare: yes

From CANHR questionnaire returned 1/1/1990:
"Alzheimer's Unit": Unk.Wanderer alert: Unk.
Locked Ward: Unk.
Types of Residents Accepted:
Types of Residents Not Accepted:
Languages spoken by direct-care staff:
Family Council: Not Specified

Violations Record
From Dept. of Public Health as of 4/30/2008;
Citations as of 5/1/2009.
Last DHS Certification Inspection = 11/22/2005.
How to interpret violations data.
Year Citations Deficiencies Complaints
  AA A B Rec'd Ca. Avg Rec'd Ca. Avg
2003 1 1 0 11 15 1 8.5
2004 0 0 0 22 17.8 2 9.2
2005 0 0 0 8 19.6 2 10.4
2006 0 0 0 0 20.8 3 12.5
2007 0 0 0 0 21.7 0 14.8
2008 0 0 0 0 12.1 0 6.3

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City: San Andreas

Mark Twain Convalescent Hospital
(209) 754-3823 — 900 Mountain Ranch Road — San Andreas, CA 95249

Services
How to interpret services information.

Cap.= 99 Type = SNF Medi-Cal: yes Medicare: yes

From CANHR questionnaire returned 4/20/2005:
"Alzheimer's Unit": NoWanderer alert: Yes
Locked Ward: No
Types of Residents Accepted: A D I L M S T U V
Types of Residents Not Accepted: B E F J N O P Q R
Languages spoken by direct-care staff:
Family Council: No Family Council

Violations Record
From Dept. of Public Health as of 4/30/2008;
Citations as of 5/1/2009.
Last DHS Certification Inspection = 2/26/2007.
How to interpret violations data.
Year Citations Deficiencies Complaints
  AA A B Rec'd Ca. Avg Rec'd Ca. Avg
2003 0 0 0 4 15 14 8.5
2004 0 0 0 20 17.8 6 9.2
2005 0 0 0 20 19.6 9 10.4
2006 0 0 0 2 20.8 23 12.5
2007 0 0 0 17 21.7 52 14.8
2008 0 0 0 0 12.1 16 6.3

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© 2008

California Advocates for Nursing Home Reform
( CANHR )
650 Harrison Street, 2nd Floor
San Francisco, CA 94107
Tel: (800) 474-1116 (consumers only)
Tel: (415) 974-5171