Bethel Center - Arpin Nursing Home

General Information

UPDATE
Federal Provider Number
525360
Provider Name
BETHEL CENTER
Provider Address
8014 BETHEL RD
ARPIN, WI 54410
Provider Phone Number
7156522103
Provider SSA County
700
Provider County Name
Wood
Ownership Type
Non profit - Corporation
Number of Certified Beds
111
Number of Residents in Certified Beds
62
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AMERICAN EAGLE NURSING HOME COMPANY OF ARPIN LLC
Date First Approved to Provide Medicare and Medicaid services
1986-02-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
5
QM Rating Footnote
Staffing Rating
3
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
2.35565
Reported LPN Staffing Hours per Resident per Day
0.46371
Reported RN Staffing Hours per Resident per Day
0.99677
Reported Licensed Staffing Hours per Resident per Day
1.46048
Reported Total Nurse Staffing Hours per Resident per Day
3.81613
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09194
Expected CNA Staffing Hours per Resident per Day
2.49785
Expected LPN Staffing Hours per Resident per Day
0.68443
Expected RN Staffing Hours per Resident per Day
1.20258
Expected Total Nurse Staffing Hours per Resident per Day
4.38487
Adjusted CNA Staffing Hours per Resident per Day
2.31401
Adjusted LPN Staffing Hours per Resident per Day
0.56233
Adjusted RN Staffing Hours per Resident per Day
0.61932
Adjusted Total Nurse Staffing Hours per Resident per Day
3.50808
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-02-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
18
Cycle 2 Number of Standard Health Deficiencies
18
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
120
Cycle 2 Standard Health Survey Date
2012-12-13
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
12
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2011-11-10
Cycle 3 Number of Health Revisits
3
Cycle 3 Health Revisit Score
50
Cycle 3 Total Health Score
122
Total Weighted Health Survey Score
90.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
11700
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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