Wisconsin Nursing Homes >> Hammond Nursing Homes >> American Heritage Care Ctr

American Heritage Care Ctr - Hammond Nursing Home

General Information

UPDATE
Federal Provider Number
525499
Provider Name
AMERICAN HERITAGE CARE CTR
Provider Address
425 DAVIS ST
HAMMOND, WI 54015
Provider Phone Number
(715) 796-2218
Provider SSA County
540
Provider County Name
St. Croix
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
35
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EXTENDICARE HOMES, INC
Date First Approved to Provide Medicare and Medicaid services
1992-12-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
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
2.14000
Reported LPN Staffing Hours per Resident per Day
0.43857
Reported RN Staffing Hours per Resident per Day
1.39714
Reported Licensed Staffing Hours per Resident per Day
1.83571
Reported Total Nurse Staffing Hours per Resident per Day
3.97571
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01429
Expected CNA Staffing Hours per Resident per Day
2.58772
Expected LPN Staffing Hours per Resident per Day
0.64686
Expected RN Staffing Hours per Resident per Day
0.96911
Expected Total Nurse Staffing Hours per Resident per Day
4.20369
Adjusted CNA Staffing Hours per Resident per Day
2.02917
Adjusted LPN Staffing Hours per Resident per Day
0.56274
Adjusted RN Staffing Hours per Resident per Day
1.07722
Adjusted Total Nurse Staffing Hours per Resident per Day
3.81230
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-10-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-10-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2012-11-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
24.00000
Number of Facility Reported Incidents
1
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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