Columbus Health And Rehab - Columbus Nursing Home
General Information
UPDATEFederal Provider Number
525445
Provider Name
COLUMBUS HEALTH AND REHAB
Provider Address
825 WESTERN AVE
COLUMBUS, WI 53925
COLUMBUS, WI 53925
Provider Phone Number
(920) 623-2520
Provider SSA County
100
Provider County Name
Columbia
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
30
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HEYDE HEALTH SYSTEM COLUMBUS LLC
Date First Approved to Provide Medicare and Medicaid services
1989-11-01
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
4
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
2.94500
Reported LPN Staffing Hours per Resident per Day
0.88667
Reported RN Staffing Hours per Resident per Day
1.17667
Reported Licensed Staffing Hours per Resident per Day
2.06333
Reported Total Nurse Staffing Hours per Resident per Day
5.00834
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14833
Expected CNA Staffing Hours per Resident per Day
2.53896
Expected LPN Staffing Hours per Resident per Day
0.69009
Expected RN Staffing Hours per Resident per Day
1.27845
Expected Total Nurse Staffing Hours per Resident per Day
4.50749
Adjusted CNA Staffing Hours per Resident per Day
2.84611
Adjusted LPN Staffing Hours per Resident per Day
1.06644
Adjusted RN Staffing Hours per Resident per Day
0.68771
Adjusted Total Nurse Staffing Hours per Resident per Day
4.47879
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-05-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-02-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
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
2011-12-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
48.66700
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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