Anna John Resident Centered Care Community - Oneida Nursing Home
General Information
UPDATEFederal Provider Number
525695
Provider Name
ANNA JOHN RESIDENT CENTERED CARE COMMUNITY
Provider Address
2901 SOUTH OVERLAND ROAD
ONEIDA, WI 54155
ONEIDA, WI 54155
Provider Phone Number
(920) 869-2797
Provider SSA County
40
Provider County Name
Brown
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
48
Number of Residents in Certified Beds
40
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2008-10-01
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
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.26000
Reported LPN Staffing Hours per Resident per Day
1.00000
Reported RN Staffing Hours per Resident per Day
0.89750
Reported Licensed Staffing Hours per Resident per Day
1.89750
Reported Total Nurse Staffing Hours per Resident per Day
5.15750
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07000
Expected CNA Staffing Hours per Resident per Day
2.20713
Expected LPN Staffing Hours per Resident per Day
0.59613
Expected RN Staffing Hours per Resident per Day
0.98484
Expected Total Nurse Staffing Hours per Resident per Day
3.78810
Adjusted CNA Staffing Hours per Resident per Day
3.62420
Adjusted LPN Staffing Hours per Resident per Day
1.39231
Adjusted RN Staffing Hours per Resident per Day
0.68093
Adjusted Total Nurse Staffing Hours per Resident per Day
5.48808
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-08-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-09-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-08-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
40.66700
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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