Madonna Manor

Total Number of Beds: 35	Percent of Occupied Beds: 100%
Total Number of Residents: 35	Located Within a Hospital: No
Type of Ownership: Non profit - Church related	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 06/26/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.63

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.85

Number of CNA Hours per Nursing Home Resident per Day: 3.27

Number of Staff Hours per Nursing Home Resident per Day: 4.75

Nursing Home Resident Information**:

Percent of Residents Who Have Moderate to Severe Pain: 6%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 0%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 18%
Percent of Residents Who are More Depressed or Anxious: 0%
Percent of Residents Who Were Physically Restrained: 0%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 3%
Percent of Residents With a Urinary Tract Infection: 6%
** Details Last Reported on: 6/26/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-10-04	2001-10-08	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.	Pattern	Minimal harm or potential for actual harm
2002-09-05	2002-09-11	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Pattern	Minimal harm or potential for actual harm
2002-09-05	2002-09-11	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Pattern	Minimal harm or potential for actual harm
2002-09-05	2002-09-11	Quality Care Deficiencies	Make sure that residents with loss of bladder control receive treatment or service to prevent infections and help get normal bladder control.	Pattern	Minimal harm or potential for actual harm
2003-06-26	2003-07-10	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Isolated	Minimal harm or potential for actual harm
2003-06-26	2003-07-10	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2003-06-26	2003-07-10	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Minimal harm or potential for actual harm
2003-06-26	2003-07-10	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
2003-06-26	2003-07-10	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Minimal harm or potential for actual harm
2003-06-26	2003-07-10	Environmental Deficiencies	Have a program to keep infection from spreading.	Widespread	Minimal harm or potential for actual harm
2003-06-26	2003-07-10	Administration Deficiencies	Follow all laws and professional standards.	Widespread	Potential for minimal harm

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