Madison County Hospital Extended Center

Total Number of Beds: 11	Percent of Occupied Beds: 100%
Total Number of Residents: 11	Located Within a Hospital: Yes
Type of Ownership: Non profit - Corporation	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: 09/19/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 2.39

Number of LPN/LVN Hours per Nursing Home Resident per Day: 1.04

Number of CNA Hours per Nursing Home Resident per Day: 2.45

Number of Staff Hours per Nursing Home Resident per Day: 5.88

Nursing Home Resident Information**:

** Details Last Reported on: 9/19/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-10-12	2001-12-01	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
2001-10-12	2001-12-01	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Minimal harm or potential for actual harm
2001-10-12	2001-12-01	Nutrition and Dietary Deficiencies	Make sure that residents are well nourished.	Isolated	Minimal harm or potential for actual harm
2001-10-12	2001-12-01	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2002-07-18	2002-07-22	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Widespread	Potential for minimal harm
2002-07-18	2002-07-22	Pharmacy Service Deficiencies	Make sure that the pharmacist reports anything unusual to the doctor on duty and the director of nursing.	Isolated	Minimal harm or potential for actual harm
2002-07-18	2002-07-22	Administration Deficiencies	Make sure that nurse aides show they have the skills to be able to care for residents.	Pattern	Minimal harm or potential for actual harm
2003-09-19	2003-11-08	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm

*** All violations listed are based on federal government records.