Frederic Nursing And Rehab Community - Frederic Nursing Home
General Information
UPDATEFederal Provider Number
525665
Provider Name
FREDERIC NURSING AND REHAB COMMUNITY
Provider Address
205 UNITED WAY
FREDERIC, WI 54837
FREDERIC, WI 54837
Provider Phone Number
(715) 327-4297
Provider SSA County
470
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ORION FREDERIC LLC
Date First Approved to Provide Medicare and Medicaid services
2002-05-25
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
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.03837
Reported LPN Staffing Hours per Resident per Day
0.55814
Reported RN Staffing Hours per Resident per Day
0.69302
Reported Licensed Staffing Hours per Resident per Day
1.25116
Reported Total Nurse Staffing Hours per Resident per Day
3.28953
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10000
Expected CNA Staffing Hours per Resident per Day
2.43681
Expected LPN Staffing Hours per Resident per Day
0.67426
Expected RN Staffing Hours per Resident per Day
1.31739
Expected Total Nurse Staffing Hours per Resident per Day
4.42846
Adjusted CNA Staffing Hours per Resident per Day
2.05250
Adjusted LPN Staffing Hours per Resident per Day
0.68706
Adjusted RN Staffing Hours per Resident per Day
0.39307
Adjusted Total Nurse Staffing Hours per Resident per Day
2.99422
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-10-22
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
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-12-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-11-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
14.00000
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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