Manawa Com Nur Ctr - Manawa Nursing Home
General Information
UPDATEFederal Provider Number
525316
Provider Name
MANAWA COM NUR CTR
Provider Address
400 EAST 4TH ST
MANAWA, WI 54949
MANAWA, WI 54949
Provider Phone Number
9205962566
Provider SSA County
670
Provider County Name
Waupaca
Ownership Type
For profit - Partnership
Number of Certified Beds
15
Number of Residents in Certified Beds
13
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MANAWA COMMUNITY NURSING CENTER INC.
Date First Approved to Provide Medicare and Medicaid services
1982-06-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
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
4.95385
Reported LPN Staffing Hours per Resident per Day
1.38846
Reported RN Staffing Hours per Resident per Day
1.52692
Reported Licensed Staffing Hours per Resident per Day
2.91538
Reported Total Nurse Staffing Hours per Resident per Day
7.86923
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.29762
Expected LPN Staffing Hours per Resident per Day
0.48524
Expected RN Staffing Hours per Resident per Day
0.58583
Expected Total Nurse Staffing Hours per Resident per Day
3.36869
Adjusted CNA Staffing Hours per Resident per Day
5.29037
Adjusted LPN Staffing Hours per Resident per Day
2.37496
Adjusted RN Staffing Hours per Resident per Day
1.94751
Adjusted Total Nurse Staffing Hours per Resident per Day
9.41615
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2015-04-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
15
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
124
Cycle 2 Standard Health Survey Date
2014-06-23
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
12
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2013-04-24
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
44
Cycle 3 Total Health Score
132
Total Weighted Health Survey Score
69.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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Greentree Health And Rehab Ctr
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