Benedictine Manor Of Lacrosse - La Crosse Nursing Home
General Information
UPDATEFederal Provider Number
525438
Provider Name
BENEDICTINE MANOR OF LACROSSE
Provider Address
2902 E AVENUE SOUTH
LA CROSSE, WI 54601
LA CROSSE, WI 54601
Provider Phone Number
(608) 788-9870
Provider SSA County
310
Provider County Name
La Crosse
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
76
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
1989-10-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
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
2.73684
Reported LPN Staffing Hours per Resident per Day
0.38553
Reported RN Staffing Hours per Resident per Day
0.99671
Reported Licensed Staffing Hours per Resident per Day
1.38224
Reported Total Nurse Staffing Hours per Resident per Day
4.11908
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07434
Expected CNA Staffing Hours per Resident per Day
2.54428
Expected LPN Staffing Hours per Resident per Day
0.65706
Expected RN Staffing Hours per Resident per Day
1.05193
Expected Total Nurse Staffing Hours per Resident per Day
4.25327
Adjusted CNA Staffing Hours per Resident per Day
2.63940
Adjusted LPN Staffing Hours per Resident per Day
0.48700
Adjusted RN Staffing Hours per Resident per Day
0.70798
Adjusted Total Nurse Staffing Hours per Resident per Day
3.90372
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
15
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
159
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
159
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2014-02-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
92
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2013-01-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
120.83300
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
36855
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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