Cumberland Mem Hsptl Ecu - Cumberland Nursing Home

General Information

UPDATE
Federal Provider Number
525712
Provider Name
CUMBERLAND MEM HSPTL ECU
Provider Address
1110 7TH AVE
CUMBERLAND, WI 54829
Provider Phone Number
7158226113
Provider SSA County
20
Provider County Name
Barron
Ownership Type
Non profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
46
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
CUMBERLAND MEMORIAL HOSPITAL INC
Date First Approved to Provide Medicare and Medicaid services
2013-08-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
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
2.69674
Reported LPN Staffing Hours per Resident per Day
0.09565
Reported RN Staffing Hours per Resident per Day
1.04239
Reported Licensed Staffing Hours per Resident per Day
1.13804
Reported Total Nurse Staffing Hours per Resident per Day
3.83478
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.56859
Expected LPN Staffing Hours per Resident per Day
0.62858
Expected RN Staffing Hours per Resident per Day
0.91338
Expected Total Nurse Staffing Hours per Resident per Day
4.11055
Adjusted CNA Staffing Hours per Resident per Day
2.57612
Adjusted LPN Staffing Hours per Resident per Day
0.12630
Adjusted RN Staffing Hours per Resident per Day
0.85274
Adjusted Total Nurse Staffing Hours per Resident per Day
3.76048
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-05-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-04-11
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
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
-0001-11-30
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
35.20000
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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