Golden Livingcenter-golden Age - Tomahawk Nursing Home
General Information
UPDATEFederal Provider Number
525334
Provider Name
GOLDEN LIVINGCENTER-GOLDEN AGE
Provider Address
720 E KINGS RD
TOMAHAWK, WI 54487
TOMAHAWK, WI 54487
Provider Phone Number
(715) 453-2164
Provider SSA County
340
Provider County Name
Lincoln
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
83
Number of Residents in Certified Beds
51
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GGNSC TOMAHAWK GOLDEN AGE LLC
Date First Approved to Provide Medicare and Medicaid services
1983-12-01
Continuing Care Retirement Community
N
Special Focus Facility
Y
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
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
1.84118
Reported LPN Staffing Hours per Resident per Day
0.38235
Reported RN Staffing Hours per Resident per Day
0.90490
Reported Licensed Staffing Hours per Resident per Day
1.28725
Reported Total Nurse Staffing Hours per Resident per Day
3.12843
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.39783
Expected LPN Staffing Hours per Resident per Day
0.62943
Expected RN Staffing Hours per Resident per Day
1.00000
Expected Total Nurse Staffing Hours per Resident per Day
4.02727
Adjusted CNA Staffing Hours per Resident per Day
1.88408
Adjusted LPN Staffing Hours per Resident per Day
0.50419
Adjusted RN Staffing Hours per Resident per Day
0.67614
Adjusted Total Nurse Staffing Hours per Resident per Day
3.13125
Cycle 1 Total Number of Health Deficiencies
29
Cycle 1 Number of Standard Health Deficiencies
21
Cycle 1 Number of Complaint Health Deficiencies
24
Cycle 1 Health Deficiency Score
448
Cycle 1 Standard Survey Health Date
2014-06-25
Cycle 1 Number of Health Revisits
3
Cycle 1 Health Revisit Score
314
Cycle 1 Total Health Score
762
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-09-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-07-03
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
393.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
10
Number of Fines
2
Total Amount of Fines in Dollars
54860
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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