{"schema_version":"1.0.0","facility":{"id":"cms-26e421","ccn":"26E421","name":"Madison Medical Center","source_name":"MADISON MEDICAL CENTER","facility_types":["nursing_home"],"primary_type":"nursing_home","universe":"cms_certified_nursing_homes","source_type_label":"Medicaid","status":"active","status_label":"Active CMS certification","status_evidence":"VERIFIED","state":"MO","address":{"line1":"611 West Main Street","city":"Fredericktown","state":"MO","zip":"63645","county_name":"Madison County","county_fips":"29123","county_method":"name_match","ssa_county_code":"601","urban":false},"location":{"lat":37.5598,"lon":-90.303,"method":"cms_published_coordinates"},"phone":"5737833341","certification":{"authority":"CMS","ccn":"26E421","program":"Medicaid","medicare":false,"medicaid":true,"first_approved":"2024-10-01","certified_beds":99,"resides_in_hospital":true,"evidence_class":"VERIFIED","care_compare_url":"https://www.medicare.gov/care-compare/details/nursing-home/26E421"},"licenses":[],"license_note":"State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead.","capacity":{"certified_beds":99,"avg_residents_per_day":64.1},"ownership_type":"Government - City/county","ownership_class":"government","legal_business_name_note":"CMS reports the legal business name as not available.","flags":{"ccrc":false,"abuse_icon":false,"high_performing":true,"inspection_over_2y":false,"changed_ownership_12mo":false,"resident_family_council":"Resident","sprinklers_all_areas":"Yes"},"ratings":{"overall":{"value":5},"health_inspection":{"value":4},"quality_measures":{"value":3},"long_stay_qm":{"value":3},"short_stay_qm":{"footnote":"2"},"staffing":{"value":5},"universe":"cms_certified_nursing_homes"},"staffing":{"nurse_aide_hprd":3.03085,"lpn_hprd":0.42154,"rn_hprd":0.56446,"licensed_hprd":0.986,"total_nurse_hprd":4.01685,"weekend_total_nurse_hprd":3.45443,"weekend_rn_hprd":0.37722,"pt_hprd":0,"nursing_turnover_pct":33.9,"rn_turnover_pct":25,"administrators_left":0,"case_mix_index":1.09439,"case_mix_index_ratio":0.77602,"case_mix_total_nurse_hprd":3.02714,"adjusted_total_nurse_hprd":5.1356,"source":"Payroll-Based Journal (PBJ), as published by CMS"},"health_survey_score":{"cycle1_date":"2025-11-17","cycle1_deficiencies":4,"cycle1_score":32,"cycle2_date":"2024-09-13","cycle23_deficiencies":1,"cycle23_score":4,"total_weighted_score":25},"cms_penalty_counts":{"fines":0,"fine_total":0,"payment_denials":0,"total":0},"first_seen":"2026-11-07T00:15:24.640Z","last_changed":"2026-11-07T00:15:24.640Z","profile_url":"https://www.medicare.gov/care-compare/details/nursing-home/26E421","provenance":[{"source_id":"cms_provider_info","source_record_id":"26E421","url":"https://data.cms.gov/provider-data/api/1/datastore/query/4pq5-n9py/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=26E421&conditions%5B0%5D%5Boperator%5D=%3D","retrieved_at":"2026-11-07T00:15:24.640Z","source_updated_at":"2026-10-01","effective_date":"2026-10-01","jurisdiction":"US-CMS","fields":["name","address","phone","certification","certified_beds","ownership_type","legal_business_name","chain"],"evidence_class":"VERIFIED","status":"current"},{"source_id":"cms_provider_info","source_record_id":"26E421","url":"https://data.cms.gov/provider-data/api/1/datastore/query/4pq5-n9py/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=26E421&conditions%5B0%5D%5Boperator%5D=%3D","retrieved_at":"2026-11-07T00:15:24.640Z","source_updated_at":"2026-10-01","effective_date":"2026-10-01","jurisdiction":"US-CMS","fields":["ratings","staffing","health_survey_score"],"evidence_class":"VERIFIED","status":"current","note":"Five-Star ratings and PBJ staffing apply to the CMS-certified universe only."}],"ownership_not_available":true,"inspection_summary":{"count":4,"health_count":2,"fire_count":2,"complaint_count":0,"latest_date":"2025-11-17","latest_standard_health":"2025-11-17","earliest_date":"2024-09-13","window_note":"CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.","evidence_class":"VERIFIED"},"deficiency_summary":{"count":7,"health_count":5,"fire_count":2,"open_count":0,"actual_harm_count":0,"immediate_jeopardy_count":0,"serious_count":0,"complaint_count":0,"by_severity":{"potential":7},"by_scope_severity":{"F":3,"E":1,"D":3},"by_concept":{"environment_life_safety":2,"administration":1,"resident_rights":1,"medication":1,"infection_prevention":2},"type_ids":["cms-k0920","cms-f0868","cms-f0628","cms-f0759","cms-f0880","cms-k0923"],"evidence_class":"VERIFIED"},"penalty_summary":{"count":0,"fines":0,"fine_total":0,"payment_denials":0},"ownership_summary":{"disclosures":0,"organizations":0,"individuals":0,"not_available":true}},"row":{"id":"cms-26e421","ccn":"26E421","name":"Madison Medical Center","types":["nursing_home"],"status":"active","state":"MO","city":"Fredericktown","zip":"63645","county_fips":"29123","county_name":"Madison County","address":"611 West Main Street","beds":99,"residents":64.1,"ownership":"government","lat":37.5598,"lon":-90.303,"overall":5,"health_rating":4,"staffing_rating":5,"qm_rating":3,"nurse_hprd":4.02,"turnover":33.9,"inspections":4,"last_inspection":"2025-11-17","deficiencies":7,"serious":0,"ij":0,"open":0,"penalties":0,"fines_total":0,"deficiency_type_ids":["cms-k0920","cms-f0868","cms-f0628","cms-f0759","cms-f0880","cms-k0923"],"universe":"cms","state_actions":0,"state_serious":0,"last_changed":"2026-11-07T00:15:24.640Z"},"ownership":[],"inspections":[{"id":"cms-26e421-20251117-fire","ccn":"26E421","date":"2025-11-17","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[1],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":1,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-k0920","ss":"F","sl":2,"cs":"corrected","cd":"2025-12-03","std":1,"tv":"New"}]},{"id":"cms-26e421-20251117-health","ccn":"26E421","date":"2025-11-17","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Standard"],"cycles":[1],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":4,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0628","ss":"E","sl":2,"cs":"corrected","cd":"2025-12-03","std":1},{"t":"cms-f0759","ss":"D","sl":2,"cs":"corrected","cd":"2025-12-03","std":1},{"t":"cms-f0868","ss":"F","sl":2,"cs":"corrected","cd":"2025-12-03","std":1},{"t":"cms-f0880","ss":"D","sl":2,"cs":"corrected","cd":"2025-12-03","std":1}]},{"id":"cms-26e421-20240913-fire","ccn":"26E421","date":"2024-09-13","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[2],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":1,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-k0923","ss":"F","sl":2,"cs":"corrected","cd":"2024-10-25","std":1,"tv":"New"}]},{"id":"cms-26e421-20240913-health","ccn":"26E421","date":"2024-09-13","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Standard"],"cycles":[2],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":1,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0880","ss":"D","sl":2,"cs":"corrected","cd":"2024-10-25","std":1}]}],"deficiency_types":{"cms-k0920":{"code":"K-0920","title":"Ensure proper usage of power strips and extension cords.","category":"Gas, Vacuum, and Electrical Systems Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-f0868":{"code":"F-0868","title":"Have the Quality Assessment and Assurance group have the required members and meet at least quarterly","category":"Administration Deficiencies","concept":"administration","concept_label":"Administration & records"},"cms-f0628":{"code":"F-0628","title":"Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.","category":"Resident Rights Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"cms-f0759":{"code":"F-0759","title":"Ensure medication error rates are not 5 percent or greater.","category":"Pharmacy Service Deficiencies","concept":"medication","concept_label":"Medication management"},"cms-f0880":{"code":"F-0880","title":"Provide and implement an infection prevention and control program.","category":"Infection Control Deficiencies","concept":"infection_prevention","concept_label":"Infection prevention"},"cms-k0923":{"code":"K-0923","title":"Have proper medical gas storage and administration areas.","category":"Gas, Vacuum, and Electrical Systems Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"}},"penalties":[],"state_actions":[],"record_urls":{"cms_provider_info":"https://data.cms.gov/provider-data/api/1/datastore/query/4pq5-n9py/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=26E421&conditions%5B0%5D%5Boperator%5D=%3D","cms_ownership":"https://data.cms.gov/provider-data/api/1/datastore/query/y2hd-n93e/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=26E421&conditions%5B0%5D%5Boperator%5D=%3D","cms_health_deficiencies":"https://data.cms.gov/provider-data/api/1/datastore/query/r5ix-sfxw/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=26E421&conditions%5B0%5D%5Boperator%5D=%3D","cms_fire_safety_deficiencies":"https://data.cms.gov/provider-data/api/1/datastore/query/ifjz-ge4w/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=26E421&conditions%5B0%5D%5Boperator%5D=%3D","cms_penalties":"https://data.cms.gov/provider-data/api/1/datastore/query/g6vv-u9sr/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=26E421&conditions%5B0%5D%5Boperator%5D=%3D","cms_inspection_dates":"https://data.cms.gov/provider-data/api/1/datastore/query/svdt-c123/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=26E421&conditions%5B0%5D%5Boperator%5D=%3D"},"compact_keys":{"t":"deficiency_type_id","ss":"scope_severity_code","sl":"severity_level (1–4)","cs":"correction_status","cd":"correction_date","cmp":"complaint","std":"standard survey","ic":"infection control","idr":"under IDR","iidr":"under IIDR","tv":"tag version"},"benchmarks":{"state":{"key":"MO","overall_rating":2.6,"health_inspection_rating":2.8,"qm_rating":2.9,"staffing_rating":2.2,"avg_residents_per_day":73.1,"cycle1_health_deficiencies":11.4,"cycle1_fire_deficiencies":6,"nurse_aide_hprd":2.26,"lpn_hprd":0.68,"rn_hprd":0.46019,"licensed_hprd":1.14,"total_nurse_hprd":3.39922,"weekend_total_nurse_hprd":2.96333,"weekend_rn_hprd":0.32,"pt_hprd":0.04,"nursing_turnover_pct":56.9,"rn_turnover_pct":50,"administrators_left":0.7,"case_mix_index":1.34706,"fines":0.8,"fine_amount":36774,"processing_note":"CMS State and US Averages"},"nation":{"key":"NATION","overall_rating":3,"health_inspection_rating":2.8,"qm_rating":3.7,"staffing_rating":3,"avg_residents_per_day":85.7,"cycle1_health_deficiencies":9.2,"cycle1_fire_deficiencies":4.4,"nurse_aide_hprd":2.35,"lpn_hprd":0.86,"rn_hprd":0.69164,"licensed_hprd":1.55,"total_nurse_hprd":3.90085,"weekend_total_nurse_hprd":3.43303,"weekend_rn_hprd":0.48,"pt_hprd":0.07,"nursing_turnover_pct":45.3,"rn_turnover_pct":42.5,"administrators_left":0.5,"case_mix_index":1.41025,"fines":0.9,"fine_amount":30351,"processing_note":"CMS State and US Averages"}},"geo":{"state":{"code":"MO","name":"Missouri"},"county":{"fips":"29123","name":"Madison County"},"zip":"63645","city":"Fredericktown"},"related":{"same_operator":[],"same_operator_total":0,"same_chain":[],"same_chain_total":0,"same_site_review":[],"nearby":[{"id":"cms-265514","ccn":"265514","name":"Claru Deville Nursing Center","address":"105 Spruce Street","city":"Fredericktown","state":"MO","zip":"63645","beds":90,"overall":3,"inspections":9,"last_inspection":"2026-04-24","deficiencies":43,"serious":4,"ij":2,"open":0,"fines_total":81964,"status":"active","universe":"cms","licensed_beds":90,"state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"],"distance_km":1.6}]}}