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Burnett Medical Center - Grantsburg Nursing Home

General Information

UPDATE
Federal Provider Number
525558
Provider Name
BURNETT MEDICAL CENTER
Provider Address
257 W ST GEORGE AVE
GRANTSBURG, WI 54840
Provider Phone Number
7154635355
Provider SSA County
60
Provider County Name
Burnett
Ownership Type
Non profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BURNETT MEDICAL CENTER INC
Date First Approved to Provide Medicare and Medicaid services
1995-03-01
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
4
Health Inspection Rating Footnote
QM Rating
4
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
2.68800
Reported LPN Staffing Hours per Resident per Day
0.34300
Reported RN Staffing Hours per Resident per Day
0.95400
Reported Licensed Staffing Hours per Resident per Day
1.29700
Reported Total Nurse Staffing Hours per Resident per Day
3.98500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02900
Expected CNA Staffing Hours per Resident per Day
2.36366
Expected LPN Staffing Hours per Resident per Day
0.52181
Expected RN Staffing Hours per Resident per Day
0.65859
Expected Total Nurse Staffing Hours per Resident per Day
3.54407
Adjusted CNA Staffing Hours per Resident per Day
2.79039
Adjusted LPN Staffing Hours per Resident per Day
0.54558
Adjusted RN Staffing Hours per Resident per Day
1.08236
Adjusted Total Nurse Staffing Hours per Resident per Day
4.53240
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
20
Cycle 1 Standard Survey Health Date
2015-02-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2014-01-17
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
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-12-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
27.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
0
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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