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Madonna Manor

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About Madonna Manor

General Information

Legal Business NameMadonna Manor, Inc.
Ownership TypeNon Profit - Corporation
Changed Ownership In The Last 12 MonthsNo
First Accepted MedicareNovember 7, 1990 (27 years)
Capacity60
Residents57
Percent Occupied95%
Program ParticipationMedicare And Medicaid
Resident And Family CouncilsResident
In HospitalNo
Continuing Care Retirement CommunityYes
Special Focus FacilityNo
Auto Sprinkler System In Required AreasYes

Ratings for Madonna Manor

Madonna Manor
was reviewed by to have a rating of 5 out of 5. About Medicare Ratings
Overall Rating
Health Inspections Rating
Quality Measures Rating
Staff Rating
RN Staff Rating

Overall Ratings of Kentucky Nursing Homes

Fines, Complaints, and Inspection Problems in the Past 3 Years

Compare The Number of Problems

Types of Problems at Nursing Homes

Some issues within a nursing home are much more severe than others. Medicare evaluates each problem based on 2 scales: the number of residents affected by a problem and the severity of the potential or actual harm to residents based on the problem. We have color coded the matrix below to make it easier to pick out the more severe problems. In general, orange and red issues related to the treatment of a resident are considered substandard quality of care.

  Residents Affected
Severity of the Deficiency Few Some Many
Immediate jeopardy to resident health or safety J K L
Actual harm that is not immediate jeopardy G H I
No actual harm with potential for more than minimal harm that is not immediate jeopardy D E F
No actual harm with potential for minimal harm A B C

October 20, 2016 - 13 months ago

 Residents AffectedSeveritySource/TypeDescription
FManyPotential for HarmHealth InspectionStore, cook, and serve food in a safe and clean way.
DFewPotential for HarmHealth InspectionMake sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

January 14, 2016 - 2 years ago

 Residents AffectedSeveritySource/TypeDescription
CManyPotential for Minimal HarmHealth InspectionGive residents a notice of rights, rules, services and charges.
DFewPotential for HarmHealth InspectionProperly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.
DFewPotential for HarmHealth InspectionHave a program that investigates, controls and keeps infection from spreading.
DFewPotential for HarmHealth InspectionAllow residents the right to participate in the planning or revision of care and treatment.
DFewPotential for HarmHealth InspectionDevelop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
DFewPotential for HarmHealth InspectionProvide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible.
DFewPotential for HarmHealth InspectionEnsure each resident receives an accurate assessment by a qualified health professional.

October 23, 2015 - 2 years ago

 Residents AffectedSeveritySource/TypeDescription
ESomePotential for HarmComplaintMake sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
DFewPotential for HarmComplaintEnsure services provided by the nursing facility meet professional standards of quality.

August 13, 2015 - 2 years ago

 Residents AffectedSeveritySource/TypeDescription
DFewPotential for HarmComplaintProvide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse.

March 27, 2015 - 3 years ago

 Residents AffectedSeveritySource/TypeDescription
FManyPotential for HarmHealth InspectionStore, cook, and serve food in a safe and clean way.
ESomePotential for HarmHealth InspectionSet up an ongoing quality assessment and assurance group to review quality deficiencies quarterly, and develop corrective plans of action.
ESomePotential for HarmHealth InspectionDevelop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
DFewPotential for HarmHealth InspectionEnsure services provided by the nursing facility meet professional standards of quality.
DFewPotential for HarmHealth InspectionLet residents refuse treatment, refuse to take part in an experiment, or formulate advance directives.

January 8, 2015 - 3 years ago

 Residents AffectedSeveritySource/TypeDescription
ESomePotential for HarmComplaintEnsure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents.
DFewPotential for HarmComplaintDevelop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property.

Staffing Levels Per Resident per Day

Medicare determines the expected staffing time per resident per day depending on level of care the residents of Madonna Manor require. It is important to compare the reported time to expected time for a single facility instead of comparing the amount of time per resident of two facilities. Learn why.

2hr 45min
2hr 40min
ReportedExpected
CNA
1hr 5min
35min
ReportedExpected
LPN
40min
1hr 5min
ReportedExpected
RN
4hr 30min
4hr 20min
ReportedExpected
Total Nursing

Quality Measures for Long Stay Residents

100.0%
100.0%
100.0%
100.0%
95.5%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
100.0%
100.0%
97.6%
95.1%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine
-
-
-
-
48.8%
Q4 2015Q1 2016Q2 2016Q3 2016KY
* The data for this facility for some quarters is unavailable.
Percentage of low risk long-stay residents who lose control of their bowels or bladder
22.5%
21.1%
19.4%
14.3%
31.9%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of long-stay residents who received an antianxiety or hypnotic medication
2.7%
26.3%
18.3%
24.4%
21.2%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of long-stay residents whose ability to move independently worsened
25.6%
23.7%
23.7%
24.4%
20.1%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of long-stay residents who received an antipsychotic medication
2.6%
23.7%
2.9%
5.9%
16.8%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of long-stay residents whose need for help with daily activities has increased
3.1%
8.5%
10.3%
7.9%
8.5%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of long-stay residents who self-report moderate to severe pain
7.5%
10.5%
5.1%
7.1%
7.5%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of long-stay residents who lose too much weight
0.0%
2.6%
0.0%
5.3%
6.2%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of high risk long-stay residents with pressure ulcers
0.0%
0.0%
2.6%
0.0%
3.1%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of long-stay residents who have depressive symptoms
0.0%
0.0%
0.0%
0.0%
5.5%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of long-stay residents with a urinary tract infection
0.0%
0.0%
0.0%
4.8%
3.8%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of long-stay residents experiencing one or more falls with major injury
5.6%
2.4%
0.0%
0.0%
3.0%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of long-stay residents with a catheter inserted and left in their bladder
0.0%
0.0%
0.0%
0.0%
1.3%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of long-stay residents who were physically restrained

Quality Measures for Short Stay Residents

97.2%
94.5%
94.9%
97.7%
84.7%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine
88.2%
69.5%
69.5%
69.5%
82.9%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine
56.6%
54.9%
61.1%
73.9%
57.3%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of short-stay residents who made improvements in function
10.4%
13.6%
15.6%
20.6%
18.3%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of short-stay residents who self-report moderate to severe pain
3.8%
3.6%
4.7%
4.2%
2.8%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of short-stay residents who newly received an antipsychotic medication
0.0%
0.7%
0.7%
0.7%
1.3%
Q4 2015Q1 2016Q2 2016Q3 2016KY
Percentage of short-stay residents with pressure ulcers that are new or worsened