Christian Community Home Of Osceola, Inc - Osceola Nursing Home
General Information
UPDATEFederal Provider Number
525706
Provider Name
CHRISTIAN COMMUNITY HOME OF OSCEOLA, INC
Provider Address
2650 65TH AVE
OSCEOLA, WI 54020
OSCEOLA, WI 54020
Provider Phone Number
(715) 294-1100
Provider SSA County
470
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
40
Number of Residents in Certified Beds
39
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CHRISTIAN COMMUNITY HOME OF OSCEOLA, INC.
Date First Approved to Provide Medicare and Medicaid services
2012-02-09
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
2.68974
Reported LPN Staffing Hours per Resident per Day
0.42436
Reported RN Staffing Hours per Resident per Day
1.22051
Reported Licensed Staffing Hours per Resident per Day
1.64487
Reported Total Nurse Staffing Hours per Resident per Day
4.33461
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07692
Expected CNA Staffing Hours per Resident per Day
2.68377
Expected LPN Staffing Hours per Resident per Day
0.60854
Expected RN Staffing Hours per Resident per Day
0.93467
Expected Total Nurse Staffing Hours per Resident per Day
4.22697
Adjusted CNA Staffing Hours per Resident per Day
2.45916
Adjusted LPN Staffing Hours per Resident per Day
0.57880
Adjusted RN Staffing Hours per Resident per Day
0.97570
Adjusted Total Nurse Staffing Hours per Resident per Day
4.13354
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2015-02-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2014-03-05
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2013-01-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
38.66700
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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