Clark County Rehabilitation & Living Center - Owen Nursing Home
General Information
UPDATEFederal Provider Number
525403
Provider Name
CLARK COUNTY REHABILITATION & LIVING CENTER
Provider Address
W4266 COUNTY HIGHWAY X
OWEN, WI 54460
OWEN, WI 54460
Provider Phone Number
(715) 229-2172
Provider SSA County
90
Provider County Name
Clark
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
172
Number of Residents in Certified Beds
161
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CLARK COUNTY
Date First Approved to Provide Medicare and Medicaid services
1987-01-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
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
2.90435
Reported LPN Staffing Hours per Resident per Day
0.19752
Reported RN Staffing Hours per Resident per Day
0.99752
Reported Licensed Staffing Hours per Resident per Day
1.19503
Reported Total Nurse Staffing Hours per Resident per Day
4.09939
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03540
Expected CNA Staffing Hours per Resident per Day
2.38145
Expected LPN Staffing Hours per Resident per Day
0.59222
Expected RN Staffing Hours per Resident per Day
0.83563
Expected Total Nurse Staffing Hours per Resident per Day
3.80931
Adjusted CNA Staffing Hours per Resident per Day
2.99246
Adjusted LPN Staffing Hours per Resident per Day
0.27682
Adjusted RN Staffing Hours per Resident per Day
0.89195
Adjusted Total Nurse Staffing Hours per Resident per Day
4.33786
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2015-02-24
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
14
Cycle 2 Number of Standard Health Deficiencies
14
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2014-03-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
92
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2013-02-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
57.33300
Number of Facility Reported Incidents
0
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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