Fox River Nursing And Rehab Center - Appleton Nursing Home
General Information
UPDATEFederal Provider Number
525407
Provider Name
FOX RIVER NURSING AND REHAB CENTER
Provider Address
601 N BRIARCLIFF DR
APPLETON, WI 54915
APPLETON, WI 54915
Provider Phone Number
(920) 739-4466
Provider SSA County
430
Provider County Name
Outagamie
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
82
Number of Residents in Certified Beds
60
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FOX RIVER NURSING AND REHAB CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
1987-03-01
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
3
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
2.63583
Reported LPN Staffing Hours per Resident per Day
0.57750
Reported RN Staffing Hours per Resident per Day
1.34250
Reported Licensed Staffing Hours per Resident per Day
1.92000
Reported Total Nurse Staffing Hours per Resident per Day
4.55583
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07250
Expected CNA Staffing Hours per Resident per Day
2.44785
Expected LPN Staffing Hours per Resident per Day
0.65504
Expected RN Staffing Hours per Resident per Day
1.06841
Expected Total Nurse Staffing Hours per Resident per Day
4.17130
Adjusted CNA Staffing Hours per Resident per Day
2.64212
Adjusted LPN Staffing Hours per Resident per Day
0.73175
Adjusted RN Staffing Hours per Resident per Day
0.93889
Adjusted Total Nurse Staffing Hours per Resident per Day
4.40249
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-11-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-11-07
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-08-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
39.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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