Maryhill Manor - Niagara Nursing Home
General Information
UPDATEFederal Provider Number
525467
Provider Name
MARYHILL MANOR
Provider Address
501 MADISON AVE
NIAGARA, WI 54151
NIAGARA, WI 54151
Provider Phone Number
7152513172
Provider SSA County
370
Provider County Name
Marinette
Ownership Type
Non profit - Church related
Number of Certified Beds
75
Number of Residents in Certified Beds
72
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MARYHILL MANOR INC
Date First Approved to Provide Medicare and Medicaid services
1990-06-01
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
2
QM Rating Footnote
Staffing Rating
4
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
2.86042
Reported LPN Staffing Hours per Resident per Day
0.32222
Reported RN Staffing Hours per Resident per Day
1.11736
Reported Licensed Staffing Hours per Resident per Day
1.43958
Reported Total Nurse Staffing Hours per Resident per Day
4.30000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02778
Expected CNA Staffing Hours per Resident per Day
2.53672
Expected LPN Staffing Hours per Resident per Day
0.63388
Expected RN Staffing Hours per Resident per Day
1.00217
Expected Total Nurse Staffing Hours per Resident per Day
4.17277
Adjusted CNA Staffing Hours per Resident per Day
2.76681
Adjusted LPN Staffing Hours per Resident per Day
0.42191
Adjusted RN Staffing Hours per Resident per Day
0.83308
Adjusted Total Nurse Staffing Hours per Resident per Day
4.15380
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2015-03-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
48
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
12
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-10-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
56.00000
Number of Facility Reported Incidents
0
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
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