Golden Livingcenter-superior - Superior Nursing Home
General Information
UPDATEFederal Provider Number
525370
Provider Name
GOLDEN LIVINGCENTER-SUPERIOR
Provider Address
1612 N 37TH ST
SUPERIOR, WI 54880
SUPERIOR, WI 54880
Provider Phone Number
(715) 392-5144
Provider SSA County
150
Provider County Name
Douglas
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
77
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GGNSC SUPERIOR LLC
Date First Approved to Provide Medicare and Medicaid services
1984-06-14
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
1.94740
Reported LPN Staffing Hours per Resident per Day
0.20844
Reported RN Staffing Hours per Resident per Day
1.20974
Reported Licensed Staffing Hours per Resident per Day
1.41818
Reported Total Nurse Staffing Hours per Resident per Day
3.36558
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07403
Expected CNA Staffing Hours per Resident per Day
2.37719
Expected LPN Staffing Hours per Resident per Day
0.64490
Expected RN Staffing Hours per Resident per Day
1.08208
Expected Total Nurse Staffing Hours per Resident per Day
4.10418
Adjusted CNA Staffing Hours per Resident per Day
2.01007
Adjusted LPN Staffing Hours per Resident per Day
0.26827
Adjusted RN Staffing Hours per Resident per Day
0.83535
Adjusted Total Nurse Staffing Hours per Resident per Day
3.30549
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
156
Cycle 1 Standard Survey Health Date
2015-02-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
156
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2014-01-30
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
34
Cycle 2 Total Health Score
102
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-11-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
115.33300
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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