Congregational Home - Brookfield Nursing Home
General Information
UPDATEFederal Provider Number
525700
Provider Name
CONGREGATIONAL HOME
Provider Address
13900 W BURLEIGH RD
BROOKFIELD, WI 53005
BROOKFIELD, WI 53005
Provider Phone Number
(262) 781-0550
Provider SSA County
660
Provider County Name
Waukesha
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
69
Number of Residents in Certified Beds
57
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
CONGREGATIONAL HOME INC
Date First Approved to Provide Medicare and Medicaid services
2010-01-01
Continuing Care Retirement Community
Y
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
4
QM Rating Footnote
Staffing Rating
5
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
4.79386
Reported LPN Staffing Hours per Resident per Day
0.73860
Reported RN Staffing Hours per Resident per Day
1.36316
Reported Licensed Staffing Hours per Resident per Day
2.10175
Reported Total Nurse Staffing Hours per Resident per Day
6.89562
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.60239
Expected LPN Staffing Hours per Resident per Day
0.59542
Expected RN Staffing Hours per Resident per Day
0.93098
Expected Total Nurse Staffing Hours per Resident per Day
4.12879
Adjusted CNA Staffing Hours per Resident per Day
4.51995
Adjusted LPN Staffing Hours per Resident per Day
1.02960
Adjusted RN Staffing Hours per Resident per Day
1.09407
Adjusted Total Nurse Staffing Hours per Resident per Day
6.73213
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2015-02-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
18
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
108
Cycle 2 Standard Health Survey Date
2013-12-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
108
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-10-05
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
38.00000
Number of Facility Reported Incidents
1
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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