Bethel Home And Services - Viroqua Nursing Home
General Information
UPDATEFederal Provider Number
525591
Provider Name
BETHEL HOME AND SERVICES
Provider Address
614 S ROCK AVE
VIROQUA, WI 54665
VIROQUA, WI 54665
Provider Phone Number
(608) 637-2171
Provider SSA County
610
Provider County Name
Vernon
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
85
Number of Residents in Certified Beds
72
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BETHEL HOME AND SERVICES INC
Date First Approved to Provide Medicare and Medicaid services
1996-09-01
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
2
Health Inspection Rating Footnote
QM Rating
5
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
2.51597
Reported LPN Staffing Hours per Resident per Day
0.47014
Reported RN Staffing Hours per Resident per Day
0.90278
Reported Licensed Staffing Hours per Resident per Day
1.37292
Reported Total Nurse Staffing Hours per Resident per Day
3.88889
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02361
Expected CNA Staffing Hours per Resident per Day
2.59554
Expected LPN Staffing Hours per Resident per Day
0.60209
Expected RN Staffing Hours per Resident per Day
0.98354
Expected Total Nurse Staffing Hours per Resident per Day
4.18117
Adjusted CNA Staffing Hours per Resident per Day
2.37848
Adjusted LPN Staffing Hours per Resident per Day
0.64810
Adjusted RN Staffing Hours per Resident per Day
0.68585
Adjusted Total Nurse Staffing Hours per Resident per Day
3.74913
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2015-01-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2014-01-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-11-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
64.00000
Number of Facility Reported Incidents
0
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
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