Bloomfield Healthcare And Rehab Center - Dodgeville Nursing Home
General Information
UPDATEFederal Provider Number
525474
Provider Name
BLOOMFIELD HEALTHCARE AND REHAB CENTER
Provider Address
3151 CTY RD CH
DODGEVILLE, WI 53533
DODGEVILLE, WI 53533
Provider Phone Number
(608) 935-3321
Provider SSA County
240
Provider County Name
Iowa
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
65
Number of Residents in Certified Beds
58
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTY OF IOWA
Date First Approved to Provide Medicare and Medicaid services
1991-08-01
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
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.75345
Reported LPN Staffing Hours per Resident per Day
0.41121
Reported RN Staffing Hours per Resident per Day
1.12931
Reported Licensed Staffing Hours per Resident per Day
1.54052
Reported Total Nurse Staffing Hours per Resident per Day
4.29397
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08103
Expected CNA Staffing Hours per Resident per Day
2.37841
Expected LPN Staffing Hours per Resident per Day
0.56583
Expected RN Staffing Hours per Resident per Day
0.95794
Expected Total Nurse Staffing Hours per Resident per Day
3.90218
Adjusted CNA Staffing Hours per Resident per Day
2.84062
Adjusted LPN Staffing Hours per Resident per Day
0.60319
Adjusted RN Staffing Hours per Resident per Day
0.88087
Adjusted Total Nurse Staffing Hours per Resident per Day
4.43562
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-06-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
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
40
Cycle 2 Standard Health Survey Date
2013-05-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
10
Cycle 3 Health Deficiency Score
393
Cycle 3 Standard Health Survey Date
2012-03-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
393
Total Weighted Health Survey Score
90.83300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
86000
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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