Golden Livingcenter-watertown - Watertown Nursing Home
General Information
UPDATEFederal Provider Number
525333
Provider Name
GOLDEN LIVINGCENTER-WATERTOWN
Provider Address
121 HOSPITAL DR
WATERTOWN, WI 53098
WATERTOWN, WI 53098
Provider Phone Number
(920) 261-9220
Provider SSA County
130
Provider County Name
Dodge
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
112
Number of Residents in Certified Beds
84
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GGNSC WATERTOWN LLC
Date First Approved to Provide Medicare and Medicaid services
1983-07-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.34048
Reported LPN Staffing Hours per Resident per Day
0.42619
Reported RN Staffing Hours per Resident per Day
0.86310
Reported Licensed Staffing Hours per Resident per Day
1.28929
Reported Total Nurse Staffing Hours per Resident per Day
3.62977
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09167
Expected CNA Staffing Hours per Resident per Day
2.52681
Expected LPN Staffing Hours per Resident per Day
0.63452
Expected RN Staffing Hours per Resident per Day
1.02860
Expected Total Nurse Staffing Hours per Resident per Day
4.18993
Adjusted CNA Staffing Hours per Resident per Day
2.27276
Adjusted LPN Staffing Hours per Resident per Day
0.55749
Adjusted RN Staffing Hours per Resident per Day
0.62698
Adjusted Total Nurse Staffing Hours per Resident per Day
3.49200
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-04-23
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
11
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
76
Cycle 2 Standard Health Survey Date
2013-01-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
76
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2011-10-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
58.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
10140
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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