Cedar Lake Health And Rehab Center - West Bend Nursing Home
General Information
UPDATEFederal Provider Number
525465
Provider Name
CEDAR LAKE HEALTH AND REHAB CENTER
Provider Address
5595 CTY RD Z
WEST BEND, WI 53095
WEST BEND, WI 53095
Provider Phone Number
(262) 306-2100
Provider SSA County
650
Provider County Name
Washington
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
215
Number of Residents in Certified Beds
190
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BENEVOLENT CORPORATION CEDAR COMMUNITY
Date First Approved to Provide Medicare and Medicaid services
1990-07-01
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
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
2.86816
Reported LPN Staffing Hours per Resident per Day
0.42789
Reported RN Staffing Hours per Resident per Day
0.92974
Reported Licensed Staffing Hours per Resident per Day
1.35763
Reported Total Nurse Staffing Hours per Resident per Day
4.22579
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11263
Expected CNA Staffing Hours per Resident per Day
2.65807
Expected LPN Staffing Hours per Resident per Day
0.64547
Expected RN Staffing Hours per Resident per Day
1.02021
Expected Total Nurse Staffing Hours per Resident per Day
4.32374
Adjusted CNA Staffing Hours per Resident per Day
2.64764
Adjusted LPN Staffing Hours per Resident per Day
0.55022
Adjusted RN Staffing Hours per Resident per Day
0.68094
Adjusted Total Nurse Staffing Hours per Resident per Day
3.93958
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-10-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-08-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
87
Cycle 3 Standard Health Survey Date
2012-05-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
87
Total Weighted Health Survey Score
19.83300
Number of Facility Reported Incidents
2
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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