Brookside Care Ctr - Kenosha Nursing Home
General Information
UPDATEFederal Provider Number
525556
Provider Name
BROOKSIDE CARE CTR
Provider Address
3506 WASHINGTON RD
KENOSHA, WI 53144
KENOSHA, WI 53144
Provider Phone Number
(262) 653-3800
Provider SSA County
290
Provider County Name
Kenosha
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
154
Number of Residents in Certified Beds
148
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BROOKSIDE CARE CENTER
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
5
Overall Rating Footnote
Health Inspection Rating
5
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
2.74392
Reported LPN Staffing Hours per Resident per Day
0.62432
Reported RN Staffing Hours per Resident per Day
0.85000
Reported Licensed Staffing Hours per Resident per Day
1.47432
Reported Total Nurse Staffing Hours per Resident per Day
4.21824
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11588
Expected CNA Staffing Hours per Resident per Day
2.53242
Expected LPN Staffing Hours per Resident per Day
0.62610
Expected RN Staffing Hours per Resident per Day
1.04522
Expected Total Nurse Staffing Hours per Resident per Day
4.20374
Adjusted CNA Staffing Hours per Resident per Day
2.65862
Adjusted LPN Staffing Hours per Resident per Day
0.82765
Adjusted RN Staffing Hours per Resident per Day
0.60764
Adjusted Total Nurse Staffing Hours per Resident per Day
4.04481
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-02-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-01-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2011-12-12
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
9.33300
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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