Capitol Lakes Health Center - Madison Nursing Home
General Information
UPDATEFederal Provider Number
525305
Provider Name
CAPITOL LAKES HEALTH CENTER
Provider Address
333 W MAIN ST
MADISON, WI 53703
MADISON, WI 53703
Provider Phone Number
(608) 283-2100
Provider SSA County
120
Provider County Name
Dane
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
85
Number of Residents in Certified Beds
74
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CAPITOL LAKES INC.
Date First Approved to Provide Medicare and Medicaid services
1979-09-04
Continuing Care Retirement Community
Y
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
2
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
2.78716
Reported LPN Staffing Hours per Resident per Day
0.81149
Reported RN Staffing Hours per Resident per Day
1.20473
Reported Licensed Staffing Hours per Resident per Day
2.01622
Reported Total Nurse Staffing Hours per Resident per Day
4.80338
Reported Physical Therapist Staffing Hours per Resident Per Day
0.20676
Expected CNA Staffing Hours per Resident per Day
2.45831
Expected LPN Staffing Hours per Resident per Day
0.69020
Expected RN Staffing Hours per Resident per Day
1.28467
Expected Total Nurse Staffing Hours per Resident per Day
4.43317
Adjusted CNA Staffing Hours per Resident per Day
2.78194
Adjusted LPN Staffing Hours per Resident per Day
0.97586
Adjusted RN Staffing Hours per Resident per Day
0.70071
Adjusted Total Nurse Staffing Hours per Resident per Day
4.36751
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
72
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
72
Cycle 2 Total Number of Health Deficiencies
16
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2013-10-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
80
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
16
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
151
Cycle 3 Standard Health Survey Date
2012-08-02
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
76
Cycle 3 Total Health Score
227
Total Weighted Health Survey Score
100.50000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
8
Number of Fines
1
Total Amount of Fines in Dollars
7500
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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