Bethel Home - Oshkosh Nursing Home
General Information
UPDATEFederal Provider Number
525554
Provider Name
BETHEL HOME
Provider Address
225 N EAGLE ST
OSHKOSH, WI 54902
OSHKOSH, WI 54902
Provider Phone Number
9202354653
Provider SSA County
690
Provider County Name
Winnebago
Ownership Type
Non profit - Corporation
Number of Certified Beds
135
Number of Residents in Certified Beds
119
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BETHEL HOME, INC.
Date First Approved to Provide Medicare and Medicaid services
1994-12-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
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
2.43824
Reported LPN Staffing Hours per Resident per Day
0.45672
Reported RN Staffing Hours per Resident per Day
0.91345
Reported Licensed Staffing Hours per Resident per Day
1.37017
Reported Total Nurse Staffing Hours per Resident per Day
3.80841
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08782
Expected CNA Staffing Hours per Resident per Day
2.52751
Expected LPN Staffing Hours per Resident per Day
0.59768
Expected RN Staffing Hours per Resident per Day
0.97419
Expected Total Nurse Staffing Hours per Resident per Day
4.09938
Adjusted CNA Staffing Hours per Resident per Day
2.36703
Adjusted LPN Staffing Hours per Resident per Day
0.63425
Adjusted RN Staffing Hours per Resident per Day
0.70062
Adjusted Total Nurse Staffing Hours per Resident per Day
3.74479
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
16
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
16
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2014-03-06
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
13
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
197
Cycle 3 Standard Health Survey Date
2013-01-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
197
Total Weighted Health Survey Score
58.16700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
2
Total Amount of Fines in Dollars
6565
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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Park View Health Center
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Omro Care Center
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Bridgewood Nursing And Rehab Center
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