Golden Livingcenter-wisconsin Dells - Wisconsin Dells Nursing Home
General Information
UPDATEFederal Provider Number
525391
Provider Name
GOLDEN LIVINGCENTER-WISCONSIN DELLS
Provider Address
300 RACE ST
WISCONSIN DELLS, WI 53965
WISCONSIN DELLS, WI 53965
Provider Phone Number
(608) 254-2574
Provider SSA County
100
Provider County Name
Columbia
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BEVERLY ENTERPRISES - WISCONSIN INC
Date First Approved to Provide Medicare and Medicaid services
1985-12-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
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
1.95692
Reported LPN Staffing Hours per Resident per Day
0.60308
Reported RN Staffing Hours per Resident per Day
0.95077
Reported Licensed Staffing Hours per Resident per Day
1.55385
Reported Total Nurse Staffing Hours per Resident per Day
3.51077
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07000
Expected CNA Staffing Hours per Resident per Day
2.51973
Expected LPN Staffing Hours per Resident per Day
0.68425
Expected RN Staffing Hours per Resident per Day
1.18827
Expected Total Nurse Staffing Hours per Resident per Day
4.39224
Adjusted CNA Staffing Hours per Resident per Day
1.90564
Adjusted LPN Staffing Hours per Resident per Day
0.73154
Adjusted RN Staffing Hours per Resident per Day
0.59786
Adjusted Total Nurse Staffing Hours per Resident per Day
3.22194
Cycle 1 Total Number of Health Deficiencies
25
Cycle 1 Number of Standard Health Deficiencies
18
Cycle 1 Number of Complaint Health Deficiencies
17
Cycle 1 Health Deficiency Score
255
Cycle 1 Standard Survey Health Date
2015-03-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
255
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2014-02-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2012-12-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
160.16700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
18
Number of Fines
1
Total Amount of Fines in Dollars
8190
Number of Payment Denials
2
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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