Family Heritage Nursing & Rehabilitation Center - Black River Falls Nursing Home
General Information
UPDATEFederal Provider Number
525488
Provider Name
FAMILY HERITAGE NURSING & REHABILITATION CENTER
Provider Address
1311 TYLER ST
BLACK RIVER FALLS, WI 54615
BLACK RIVER FALLS, WI 54615
Provider Phone Number
7152844396
Provider SSA County
260
Provider County Name
Jackson
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
39
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PFHN, LLC
Date First Approved to Provide Medicare and Medicaid services
1992-05-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.29487
Reported LPN Staffing Hours per Resident per Day
0.62436
Reported RN Staffing Hours per Resident per Day
0.78205
Reported Licensed Staffing Hours per Resident per Day
1.40641
Reported Total Nurse Staffing Hours per Resident per Day
3.70128
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00513
Expected CNA Staffing Hours per Resident per Day
2.44931
Expected LPN Staffing Hours per Resident per Day
0.61039
Expected RN Staffing Hours per Resident per Day
0.96961
Expected Total Nurse Staffing Hours per Resident per Day
4.02931
Adjusted CNA Staffing Hours per Resident per Day
2.29899
Adjusted LPN Staffing Hours per Resident per Day
0.84900
Adjusted RN Staffing Hours per Resident per Day
0.60266
Adjusted Total Nurse Staffing Hours per Resident per Day
3.70274
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
108
Cycle 1 Standard Survey Health Date
2014-12-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
108
Cycle 2 Total Number of Health Deficiencies
18
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
96
Cycle 2 Standard Health Survey Date
2014-01-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-12-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
94.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
5
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Pine View Care Center
400 County Rd R |
BLACK RIVER FALLS WI 54615 | 0.5 mile away
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