Lindengrove Mukwonago - Mukwonago Nursing Home

General Information

UPDATE
Federal Provider Number
525645
Provider Name
LINDENGROVE MUKWONAGO
Provider Address
837 CTY RD NN E
MUKWONAGO, WI 53149
Provider Phone Number
2623636830
Provider SSA County
660
Provider County Name
Waukesha
Ownership Type
Non profit - Corporation
Number of Certified Beds
69
Number of Residents in Certified Beds
64
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LINDENGROVE, INC
Date First Approved to Provide Medicare and Medicaid services
1998-10-15
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.72656
Reported LPN Staffing Hours per Resident per Day
0.67578
Reported RN Staffing Hours per Resident per Day
1.25391
Reported Licensed Staffing Hours per Resident per Day
1.92969
Reported Total Nurse Staffing Hours per Resident per Day
3.65625
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13203
Expected CNA Staffing Hours per Resident per Day
2.67431
Expected LPN Staffing Hours per Resident per Day
0.62260
Expected RN Staffing Hours per Resident per Day
1.00866
Expected Total Nurse Staffing Hours per Resident per Day
4.30557
Adjusted CNA Staffing Hours per Resident per Day
1.58413
Adjusted LPN Staffing Hours per Resident per Day
0.90090
Adjusted RN Staffing Hours per Resident per Day
0.92887
Adjusted Total Nurse Staffing Hours per Resident per Day
3.42300
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-02-27
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-02-25
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2011-12-20
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
0.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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

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