Glenhaven - Glenwood City Nursing Home

General Information

UPDATE
Federal Provider Number
525602
Provider Name
GLENHAVEN
Provider Address
612 E OAK ST
GLENWOOD CITY, WI 54013
Provider Phone Number
7152654555
Provider SSA County
540
Provider County Name
St. Croix
Ownership Type
Non profit - Corporation
Number of Certified Beds
44
Number of Residents in Certified Beds
29
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GLENHAVEN, INC.
Date First Approved to Provide Medicare and Medicaid services
1996-10-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.84138
Reported LPN Staffing Hours per Resident per Day
0.80517
Reported RN Staffing Hours per Resident per Day
0.86034
Reported Licensed Staffing Hours per Resident per Day
1.66552
Reported Total Nurse Staffing Hours per Resident per Day
4.50689
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17931
Expected CNA Staffing Hours per Resident per Day
2.62080
Expected LPN Staffing Hours per Resident per Day
0.61026
Expected RN Staffing Hours per Resident per Day
0.91325
Expected Total Nurse Staffing Hours per Resident per Day
4.14431
Adjusted CNA Staffing Hours per Resident per Day
2.66022
Adjusted LPN Staffing Hours per Resident per Day
1.09509
Adjusted RN Staffing Hours per Resident per Day
0.70391
Adjusted Total Nurse Staffing Hours per Resident per Day
4.38356
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-09-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-10-23
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-10-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
10.66700
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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