| General |
| City |
| Madison |
Iola |
| State attribute explanation |
| Wi |
Wi |
| Street |
| 4325 Nakoma Rd |
185 Chet Krause Dr Po Box 237 |
| Zip Code |
| 53,711 |
54,945 |
| Phone |
| 6,082,717,321 |
7,154,452,412 |
|
Overall Star Rating |
| 2 |
5 |
|
Health Inspections Star Rating |
| 1 |
4 |
|
Nurse Staffing Star Rating |
| 1 |
5 |
|
Quality Measures Star Rating |
| 5 |
3 |
|
RN Only Star Rating |
| 1 |
5 |
| Number of Certified Beds |
| 68 |
50 |
|
Total Number of Residents |
| 33 |
39 |
|
Percent of Occupied Beds |
| 49 % |
78 % |
| Health Survey Date |
| 12/15/2011 |
1/6/2012 |
| Fire Survey Date |
| 12/13/2011 |
1/13/2012 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| For Profit - Corporation |
Non Profit - Corporation |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| Yes |
No |
| Resident and Family Councils |
| Resident |
Both |
| Continuing Care Retirement Community? |
| No |
No |
| Quality Indicator Survey? |
| No |
No |
| Special Focus Facility? |
| No |
No |
| Civil Money Penalty Count |
| 4 |
75.2 |
| Total Enforcement Actions Count |
| 4 |
75.2 |
| # of deficiencies |
| 27 |
4 |
|
| Staff Information |
| Number of Residents |
| 33 |
39 |
| Number of RN Hours Per Resident Per Day |
| 0.36 |
1.31 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 0.9 |
0.55 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.27 |
1.86 |
| Number of CNA Hours Per Resident Per Day |
| 0.14 |
0.15 |
| Number Therapy Hours Per Resident Per Day |
| 0.14 |
0.15 |
| Environmental Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 04/04/2012date Of Correction: 05/23/2012 |
Scope: Fewlevel Of Harm: 2deficiency: Have A Program That Investigates, Controls And Keeps Infection From Spreading.survey Date: 11/05/2010date Of Correction: 12/05/2010 |
| Deficiency #2 |
| Scope: Fewlevel Of Harm: 2deficiency: Provide A Safe, Clean, Comfortable And Homelike Environment.survey Date: 04/04/2012date Of Correction: 05/23/2012 |
|
| Deficiency #3 |
| Scope: Fewlevel Of Harm: 3deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 03/03/2010date Of Correction: 04/03/2010 |
|
| Deficiency #4 |
| Scope: Somelevel Of Harm: 2deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 12/17/2009date Of Correction: 01/08/2010 |
|
| Mistreatment Deficiencies |
| Deficiency #1 |
| Scope: Manylevel Of Harm: 2deficiency: Develop Policies That Prevent Mistreatment, Neglect, Or Abuse Of Residents Or Theft Of Resident Property.survey Date: 11/03/2010date Of Correction: 12/12/2010 |
|
| Deficiency #2 |
| Scope: Manylevel Of Harm: 2deficiency: 1) Hire Only People With 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.survey Date: 11/03/2010date Of Correction: 12/12/2010 |
|
| Deficiency #3 |
| Scope: Fewlevel Of Harm: 2deficiency: 1) Hire Only People With 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.survey Date: 07/28/2010date Of Correction: 08/15/2010 |
|
| Deficiency #4 |
| Scope: Somelevel Of Harm: 2deficiency: Develop Policies That Prevent Mistreatment, Neglect, Or Abuse Of Residents Or Theft Of Resident Property.survey Date: 05/06/2010date Of Correction: 05/21/2010 |
|
| Deficiency #5 |
| Scope: Fewlevel Of Harm: 2deficiency: 1) Hire Only People With 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.survey Date: 05/06/2010date Of Correction: 05/21/2010 |
|
| Deficiency #6 |
| Scope: Fewlevel Of Harm: 2deficiency: Protect Each Resident From All Abuse, Physical Punishment, And Being Separated From Others.survey Date: 05/06/2010date Of Correction: 05/21/2010 |
|
| Resident Rights Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 4deficiency: Immediately Tell The Resident, The Resident's Doctor And A Family Member Of The Resident Of Situations (injury/decline/room, Etc.) That Affect The Resident.survey Date: 05/07/2012date Of Correction: 05/23/2012 |
Scope: Fewlevel Of Harm: 2deficiency: Give Each Resident A Notice Of Rights, Rules, Services And Charges. Tell Each Resident Who Can Get Medicaid Benefits About 1) Which Items And Services Medicaid Covers And Which The Resident Must Pay For.survey Date: 11/05/2010date Of Correction: 12/05/2010 |
| Deficiency #2 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure Each Resident Has The Right To Have A Choice Over Activities, Their Schedules And Health Care According To His Or Her Interests, Assessment, And Plan Of Care.survey Date: 04/04/2012date Of Correction: 05/23/2012 |
|
| Deficiency #3 |
| Scope: Somelevel Of Harm: 1deficiency: Tell The Resident Or The Resident's Representative In Writing How Long The Nursing Home Will Hold The Resident's Bed.survey Date: 02/28/2011date Of Correction: 02/28/2011 |
|
| Deficiency #4 |
| Scope: Somelevel Of Harm: 2deficiency: Provide Care For Residents In A Way That Keeps Or Builds Each Resident's Dignity And Respect Of Individuality.survey Date: 11/03/2010date Of Correction: 12/12/2010 |
|
| Deficiency #5 |
| Scope: Fewlevel Of Harm: 2deficiency: Immediately Tell The Resident, The Resident's Doctor And A Family Member Of The Resident Of Situations (injury/decline/room, Etc.) That Affect The Resident.survey Date: 07/28/2010date Of Correction: 08/15/2010 |
|
| Deficiency #6 |
| Scope: Fewlevel Of Harm: 2deficiency: Let The Resident Refuse Treatment Or Refuse To Take Part In An Experiment And Formulate Advance Directives.survey Date: 03/03/2010date Of Correction: 04/03/2010 |
|
| Quality Care Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure Services Provided By The Nursing Facility Meet Professional Standards Of Quality.survey Date: 10/24/2011date Of Correction: 11/02/2011 |
Scope: Fewlevel Of Harm: 2deficiency: Make Sure That Each Resident Who Enters The Nursing Home Without A Catheter Is Not Given A Catheter, And Receive Proper Services To Prevent Urinary Tract Infections And Restore Normal Bladder Function.survey Date: 11/05/2010date Of Correction: 12/05/2010 |
| Deficiency #2 |
| Scope: Somelevel Of Harm: 2deficiency: Have Enough Nurses To Care For Every Resident In A Way That Maximizes The Resident's Well Being.survey Date: 11/03/2010date Of Correction: 12/12/2010 |
|
| Deficiency #3 |
| Scope: Fewlevel Of Harm: 2deficiency: Provide Care By Qualified Persons According To Each Resident's Written Plan Of Care.survey Date: 03/03/2010date Of Correction: 04/03/2010 |
|
| Deficiency #4 |
| Scope: Fewlevel Of Harm: 2deficiency: Provide Medically-related Social Services To Help Each Resident Achieve The Highest Possible Quality Of Life.survey Date: 03/03/2010date Of Correction: 04/03/2010 |
|
| Deficiency #5 |
| Scope: Fewlevel Of Harm: 2deficiency: Give Each Resident Enough Fluids To Keep Them Healthy And Prevent Dehydration.survey Date: 11/10/2009date Of Correction: 12/17/2009 |
|
| Resident Assessment Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Develop A Complete Care Plan That Meets All Of A Resident's Needs, With Timetables And Actions That Can Be Measured.survey Date: 04/04/2012date Of Correction: 05/23/2012 |
|
| Deficiency #2 |
| Scope: Fewlevel Of Harm: 2deficiency: Develop A Complete Care Plan That Meets All Of A Resident's Needs, With Timetables And Actions That Can Be Measured.survey Date: 03/03/2010date Of Correction: 04/03/2010 |
|
| Administration Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure Medically Necessary Lab Services/tests Are Ordered By The Attending Physician.survey Date: 11/03/2010date Of Correction: 12/12/2010 |
Scope: Fewlevel Of Harm: 2deficiency: Make Sure That Nurse Aides Show They Have The Skills And Techniques To Be Able To Care For Residents' Needs.survey Date: 11/05/2010date Of Correction: 12/05/2010 |
| Pharmacy Service Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 4deficiency: 1) Make Sure That Each Resident's Drug Regimen Is Free From Unnecessary Drugs; 2) Each Resident's Entire Drug/medication Is Managed And Monitored To Achieve Highest Well Being.survey Date: 05/07/2012date Of Correction: 05/23/2012 |
|
| Nutrition and Dietary Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure That Special Or Therapeutic Diets Are Ordered By The Attending Doctor.survey Date: 03/03/2010date Of Correction: 04/03/2010 |
|
| Deficiency #2 |
| Scope: Somelevel Of Harm: 2deficiency: Provide Food In A Way That Meets A Resident's Needs.survey Date: 03/03/2010date Of Correction: 04/03/2010 |
|
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
|
28.1 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 75.2 % |
2.3 % |
| Percent of long-stay residents who lose too much weight |
|
9.1 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
|
75.2 % |
| Percent of long-stay residents with a urinary tract infection |
|
12.1:1 |
| Percent of long-stay residents who have depressive symptoms |
|
21.2:1 |
| Percent of long-stay residents who were physically restrained |
|
6.1 % |
| Percent of short-stay residents who self-report moderate to severe pain |
|
11.8:1 |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 68.2 % |
97.8 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 59.3 % |
100 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 75.2 |
75.2 |
| Percent of long-stay residents experiencing one or more falls with major injury |
|
75.2 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 32.6 % |
30.4 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 75.2 % |
1.6 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 7.5 % |
14.2 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 1.50 % |
4.9 % |
| Percent of long-stay residents who lose too much weight |
| 3.6 % |
11.4 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 26.7 % |
51.9 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 6.7 % |
2.8 % |
| Percent of long-stay residents with a urinary tract infection |
| 8.3 % |
8.6:1 |
| Percent of long-stay residents who have depressive symptoms |
| 4.7 % |
25.7 % |
| Percent of long-stay residents who were physically restrained |
| 75.2 % |
5.7 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 75.2 % |
75.2 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 25.5 % |
20.5 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 73 % |
98.2 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 61.4 % |
100 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 75.2 % |
15.7 % |