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Hospital Information 2004

Hospital Name: LAKE SHORE HOSPITAL INC

PFI # 0114

Complaints:

Complaint Information:	2004
Complaint Investigations Completed	5
Complaints with Statements of Deficiencies (SOD) Issued	2
% of Complaints with SODs Issued	4 0%
Regional % of Complaints with SODs Issued	35.5%

SOD Date	Regulatory Citation	Areas Cited	Date Plan of Correction Accepted
8/20/2004	405.5	Nursing Services Administration of Drugs	9/13/04
2/10/2004	405.19	Emergency Services Patient Care	2/26/04

SOD Date

Regulatory Citation

Areas Cited

Date Plan of Correction Accepted

8/20/2004

405.5

Nursing Services Administration of Drugs

9/13/04

2/10/2004

405.19

Emergency Services

Patient Care

2/26/04

INCIDENTS

SOD Date	Regulatory Citation	Areas Cited	Date Plan of Correction Accepted
12/21/2004	405.8	Incident Reporting	1/12/05
12/21/2004	405.6	Quality Assurance	1/12/05
12/21/2004	405.5	Nursing Services Delivery of Services	1/12/05
12/21/2004	405.4	Medical Staff Medical staff Accountability	1/12/05
12/21/2004	405.2	Governing Body Care of Patients	1/12/05
10/1/2004	405.8	Incident Reporting	11/24/04

Most Recent Survey Date: 10/1/04 (Focus)