Crossroads Care Center Of Crystal River - Waupaca Nursing Home
General Information
UPDATEFederal Provider Number
525339
Provider Name
CROSSROADS CARE CENTER OF CRYSTAL RIVER
Provider Address
1401 CHURCHILL ST
WAUPACA, WI 54981
WAUPACA, WI 54981
Provider Phone Number
7152588131
Provider SSA County
670
Provider County Name
Waupaca
Ownership Type
For profit - Corporation
Number of Certified Beds
74
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1983-11-01
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
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.41744
Reported LPN Staffing Hours per Resident per Day
0.58837
Reported RN Staffing Hours per Resident per Day
1.04535
Reported Licensed Staffing Hours per Resident per Day
1.63372
Reported Total Nurse Staffing Hours per Resident per Day
4.05116
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15465
Expected CNA Staffing Hours per Resident per Day
2.38068
Expected LPN Staffing Hours per Resident per Day
0.59678
Expected RN Staffing Hours per Resident per Day
1.00332
Expected Total Nurse Staffing Hours per Resident per Day
3.98079
Adjusted CNA Staffing Hours per Resident per Day
2.49159
Adjusted LPN Staffing Hours per Resident per Day
0.81830
Adjusted RN Staffing Hours per Resident per Day
0.77850
Adjusted Total Nurse Staffing Hours per Resident per Day
4.10216
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-06-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-03-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
14
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2012-03-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
52.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
3
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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