Colonial Center - Colby Nursing Home
General Information
UPDATEFederal Provider Number
525350
Provider Name
COLONIAL CENTER
Provider Address
702 W DOLF ST
COLBY, WI 54421
COLBY, WI 54421
Provider Phone Number
(715) 223-2352
Provider SSA County
90
Provider County Name
Clark
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
95
Number of Residents in Certified Beds
64
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AMERICAN EAGLE NURSING HOMECOMPANY OF COLBY LLC
Date First Approved to Provide Medicare and Medicaid services
1984-03-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
2.25156
Reported LPN Staffing Hours per Resident per Day
0.39141
Reported RN Staffing Hours per Resident per Day
1.05781
Reported Licensed Staffing Hours per Resident per Day
1.44922
Reported Total Nurse Staffing Hours per Resident per Day
3.70078
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03203
Expected CNA Staffing Hours per Resident per Day
2.41426
Expected LPN Staffing Hours per Resident per Day
0.68725
Expected RN Staffing Hours per Resident per Day
1.26291
Expected Total Nurse Staffing Hours per Resident per Day
4.36442
Adjusted CNA Staffing Hours per Resident per Day
2.28834
Adjusted LPN Staffing Hours per Resident per Day
0.47271
Adjusted RN Staffing Hours per Resident per Day
0.62585
Adjusted Total Nurse Staffing Hours per Resident per Day
3.41798
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-09-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-08-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
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
28
Cycle 3 Standard Health Survey Date
2012-06-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
32.00000
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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