Middleton Village Nursing & Rehab

Total Number of Beds: 97	Percent of Occupied Beds: 60%
Total Number of Residents: 58	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare Only
* Details Last Reported on: 05/14/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day:

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

Number of CNA Hours per Nursing Home Resident per Day:

Number of Staff Hours per Nursing Home Resident per Day:

Nursing Home Resident Information**:

Percent of Short-Stay Residents With Pressure Sores: 15%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 41%
Percent of Short-Stay Residents With Delirium: 1%
** Details Last Reported on: 5/14/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-08-06	2001-09-06	Resident Rights Deficiencies	Tell the resident completely about his or her health status.	Pattern	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Resident Rights Deficiencies	Try to resolve each resident's complaints quickly.	Isolated	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Resident Rights Deficiencies	Let residents give themselves their drugs if they are able.	Pattern	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Mistreatment Deficiencies	1) Hire only people who have 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
2001-08-06	2001-09-06	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Environmental Deficiencies	Keep safe, clean and homelike surroundings.	Pattern	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Resident Assessment Deficiencies	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Isolated	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Quality Care Deficiencies	Make sure that residents receive treatment/services to continue to be able to care for themselves, unless a change is unavoidable.	Isolated	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Immediate jeopardy to resident health or safety
2001-08-06	2001-09-06	Resident Assessment Deficiencies	Make sure that doctors visit residents regularly, as required.	Pattern	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Resident Assessment Deficiencies	Make sure that all needed doctor visits are made personally by a doctor, as required.	Isolated	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Pharmacy Service Deficiencies	Keep drugs and other similar products locked safely and properly stored.	Pattern	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Isolated	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Administration Deficiencies	Follow all laws and professional standards.	Isolated	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Administration Deficiencies	1) Review the work of each nurse aide every year; or 2) give regular training for the nurse aides.	Pattern	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Administration Deficiencies	Make sure that nurse aides show they have the skills to be able to care for residents.	Isolated	Minimal harm or potential for actual harm
2001-08-06	2001-09-06	Administration Deficiencies	Give or get lab tests to meet the needs of residents.	Isolated	Minimal harm or potential for actual harm
2002-06-06	2002-07-17	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Pattern	Minimal harm or potential for actual harm
2002-06-06	0000-00-00	Resident Rights Deficiencies	Allow residents to easily see the results of the nursing home's most recent survey.	Widespread	Potential for minimal harm
2002-06-06	2002-07-17	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Minimal harm or potential for actual harm
2002-06-06	2002-07-17	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
2002-06-06	0000-00-00	Quality Care Deficiencies	Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	Widespread	Potential for minimal harm
2002-06-06	2002-07-17	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.	Pattern	Minimal harm or potential for actual harm
2002-06-06	2002-07-06	Environmental Deficiencies	Make sure that staff members wash their hands when needed.	Isolated	Minimal harm or potential for actual harm
2002-06-06	2002-07-06	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
2002-06-06	2002-07-06	Administration Deficiencies	Train all employees on what to do in an emergency.	Pattern	Minimal harm or potential for actual harm
2003-05-14	2003-06-14	Resident Assessment Deficiencies	1) Develop a complete care plan within 7 days of each resident's admission; 2) prepare a care plan with the care team, including the primary nurse, doctor, resident or resident's family or representative; or 3) check and update the care plan.	Widespread	Minimal harm or potential for actual harm
2003-05-14	2003-08-02	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
2003-05-14	2003-06-14	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2003-05-14	2003-06-14	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
2003-05-14	2003-06-14	Pharmacy Service Deficiencies	Provide drugs and related services needed by each resident.	Pattern	Minimal harm or potential for actual harm
2003-05-14	2003-06-14	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Minimal harm or potential for actual harm
2003-05-14	2003-08-02	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Minimal harm or potential for actual harm

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