Villa Loretto Nursing Home - Mount Calvary Nursing Home
General Information
UPDATEFederal Provider Number
525621
Provider Name
VILLA LORETTO NURSING HOME
Provider Address
N8114 COUNTY WW
MOUNT CALVARY, WI 53057
MOUNT CALVARY, WI 53057
Provider Phone Number
9207533211
Provider SSA County
190
Provider County Name
Fond Du Lac
Ownership Type
Non 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
SSCK INC
Date First Approved to Provide Medicare and Medicaid services
1997-07-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
2.48846
Reported LPN Staffing Hours per Resident per Day
0.52949
Reported RN Staffing Hours per Resident per Day
1.20385
Reported Licensed Staffing Hours per Resident per Day
1.73333
Reported Total Nurse Staffing Hours per Resident per Day
4.22180
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03205
Expected CNA Staffing Hours per Resident per Day
2.53139
Expected LPN Staffing Hours per Resident per Day
0.63588
Expected RN Staffing Hours per Resident per Day
0.92773
Expected Total Nurse Staffing Hours per Resident per Day
4.09500
Adjusted CNA Staffing Hours per Resident per Day
2.41209
Adjusted LPN Staffing Hours per Resident per Day
0.69113
Adjusted RN Staffing Hours per Resident per Day
0.96959
Adjusted Total Nurse Staffing Hours per Resident per Day
4.15571
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2015-05-13
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2014-06-12
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
1
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2013-05-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
15.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
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
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Grancare Nursing And Rehab Ctr
517 E Division St |
FOND DU LAC WI 54935 | 9.9 miles away
Harbor Haven Health & Rehabilitation
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FOND DU LAC WI 54935 | 10.1 miles away
Transitional Care Unit
430 E Division St |
FOND DU LAC WI 54935 | 10.1 miles away
St Francis Home
33 Everett St |
FOND DU LAC WI 54935 | 10.3 miles away
All About Life Rehab Ctr
115 E Arndt St |
FOND DU LAC WI 54935 | 10.5 miles away
Fond Du Lac Lutheran Home
244 N Macy St |
FOND DU LAC WI 54935 | 10.8 miles away
Fountain View Care Ctr
50 Wolverton Ave |
RIPON WI 54971 | 29.6 miles away
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