Wisconsin Nursing Homes >> Cuba City Nursing Homes >> Epione Pavillion

Epione Pavillion - Cuba City Nursing Home

General Information

UPDATE
Federal Provider Number
525395
Provider Name
EPIONE PAVILLION
Provider Address
808 S WASHINGTON ST
CUBA CITY, WI 53807
Provider Phone Number
(608) 744-2161
Provider SSA County
210
Provider County Name
Grant
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
78
Number of Residents in Certified Beds
73
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
SOUTHWEST HEALTH CENTER, INC
Date First Approved to Provide Medicare and Medicaid services
1986-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
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
2.51986
Reported LPN Staffing Hours per Resident per Day
0.40479
Reported RN Staffing Hours per Resident per Day
1.04658
Reported Licensed Staffing Hours per Resident per Day
1.45137
Reported Total Nurse Staffing Hours per Resident per Day
3.97123
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05274
Expected CNA Staffing Hours per Resident per Day
2.58414
Expected LPN Staffing Hours per Resident per Day
0.57656
Expected RN Staffing Hours per Resident per Day
0.87449
Expected Total Nurse Staffing Hours per Resident per Day
4.03520
Adjusted CNA Staffing Hours per Resident per Day
2.39266
Adjusted LPN Staffing Hours per Resident per Day
0.58272
Adjusted RN Staffing Hours per Resident per Day
0.89424
Adjusted Total Nurse Staffing Hours per Resident per Day
3.96700
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
28
Cycle 1 Standard Survey Health Date
2014-08-21
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
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-05-23
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-04-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
28.66700
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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