Four Winds Manor - Verona Nursing Home
General Information
UPDATEFederal Provider Number
525656
Provider Name
FOUR WINDS MANOR
Provider Address
303 S JEFFERSON ST
VERONA, WI 53593
VERONA, WI 53593
Provider Phone Number
(608) 845-6465
Provider SSA County
120
Provider County Name
Dane
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
44
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FOUR WINDS MANOR, INC.
Date First Approved to Provide Medicare and Medicaid services
2000-07-01
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
2
Health Inspection Rating Footnote
QM Rating
5
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
3.00581
Reported LPN Staffing Hours per Resident per Day
0.71744
Reported RN Staffing Hours per Resident per Day
0.83488
Reported Licensed Staffing Hours per Resident per Day
1.55233
Reported Total Nurse Staffing Hours per Resident per Day
4.55813
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02442
Expected CNA Staffing Hours per Resident per Day
2.61838
Expected LPN Staffing Hours per Resident per Day
0.59503
Expected RN Staffing Hours per Resident per Day
0.83669
Expected Total Nurse Staffing Hours per Resident per Day
4.05010
Adjusted CNA Staffing Hours per Resident per Day
2.81676
Adjusted LPN Staffing Hours per Resident per Day
1.00075
Adjusted RN Staffing Hours per Resident per Day
0.74559
Adjusted Total Nurse Staffing Hours per Resident per Day
4.53652
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
84
Cycle 1 Standard Survey Health Date
2014-12-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
84
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2013-11-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
80
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
24
Cycle 3 Standard Health Survey Date
2012-08-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
72.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
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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