Crossroads Care Center Of Mayville - Mayville Nursing Home
General Information
UPDATEFederal Provider Number
525616
Provider Name
CROSSROADS CARE CENTER OF MAYVILLE
Provider Address
305 S CLARK ST
MAYVILLE, WI 53050
MAYVILLE, WI 53050
Provider Phone Number
(920) 387-0354
Provider SSA County
130
Provider County Name
Dodge
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
133
Number of Residents in Certified Beds
46
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
1997-03-19
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
4
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
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
2.33696
Reported LPN Staffing Hours per Resident per Day
0.60109
Reported RN Staffing Hours per Resident per Day
1.41739
Reported Licensed Staffing Hours per Resident per Day
2.01848
Reported Total Nurse Staffing Hours per Resident per Day
4.35544
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12283
Expected CNA Staffing Hours per Resident per Day
2.67803
Expected LPN Staffing Hours per Resident per Day
0.74395
Expected RN Staffing Hours per Resident per Day
1.28541
Expected Total Nurse Staffing Hours per Resident per Day
4.70738
Adjusted CNA Staffing Hours per Resident per Day
2.14120
Adjusted LPN Staffing Hours per Resident per Day
0.67062
Adjusted RN Staffing Hours per Resident per Day
0.82392
Adjusted Total Nurse Staffing Hours per Resident per Day
3.72954
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-06-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-03-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
21
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
9
Cycle 3 Health Deficiency Score
288
Cycle 3 Standard Health Survey Date
2012-09-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
288
Total Weighted Health Survey Score
74.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
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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