Since 2000, at least five nursing homes in or around Dane County were cited for actual harm or immediate jeopardy, and in the latest inspections, more than 16 total citations — double the state average of six and the U.S. average of eight.

Actual harm means a resident can't maintain the highest practical quality of life, while immediate jeopardy, the most severe citation, requires instant action because it has or will cause serious injury, serious harm, impairment or death.

The latest reports, which include the regularly scheduled and complaint-driven inspections between June 1, 2006 and Aug. 31, 2007, show:

• Middleton Village Nursing and Rehabilitation Center, 6201 Elmwood Ave., had a state high 52 health citations — eight times the state average — including four actual harm and two for immediate jeopardy.
The 97-bed facility, owned by Kindered Healthcare of Louisville, Ken., had deficiencies for hiring practices, policies related to abuse, quality of care, preventing bedsores, nutrition, unresolved complaints, overdose prevention and more.

In a statement, the center said: "We take seriously any issues brought to our attention by the state. We are working to address the state's concerns and have brought in an outside consultant as well as additional assistance from our regional office. In addition, a new executive director began at the center in July."
In its state consumer information report for 2006, the facility had lower staff retention rates than the Dane County or state averages in five of six nursing categories.

Attorney Matt Boller of Madison, who is representing several clients exploring lawsuits against the facility, said problems seem related to inadequate staffing and training.

Kindred, a Fortune 500 company with annual revenues of $4 billion, has paid millions of dollars to settle lawsuits in various states.

• Willows Nursing Home and Rehabilitation Center, 41 Rickel Road, Sun Prairie, had 22 health citations including failure to prevent bedsores, not offering flu vaccines or notifying doctors about health changes, and not having a program to stop infections from spreading. One citation was for actual harm and two for immediate jeopardy.

• Beverly Living Center, Wisconsin Dells, had 22 health citations, including failure to have policies that forbid abuse, not providing activities that meet the needs of each resident, not preventing bedsores, and failing to tell a doctor about health changes. Three citations were for actual harm and two for immediate jeopardy.

• Columbus Nursing and Rehabilitation Center, Columbus, had 20 health citations, including hiring people with a legal history of abuse, failing to protect residents from abuse, and failing to make sure nutritional needs were met. One citation was for actual harm and six for immediate jeopardy. Marty Metton, executive vice president at Heyde Health Systems, Columbus LLC, said the facility is appealing its recertification inspection and that the facility is currently "in full compliance." He declined further comment.

• Oak Park Nursing and Rehabilitation Center, 718 Jupiter Dr., Madison, had 18 health citations including failure to prevent bedsores, failing to give care to get the highest quality of life, failing to provide services that meet a professional standard, failing to meet nutritional needs and failing to notify a doctor about a change in health. Three citations were for actual harm and four for immediate jeopardy.

Willows, Beverley Living Center and Oak Park didn't return phone calls seeking their comment.