Grancare Nursing And Rehab Ctr - Fond Du Lac Nursing Home
General Information
UPDATEFederal Provider Number
525522
Provider Name
GRANCARE NURSING AND REHAB CTR
Provider Address
517 E DIVISION ST
FOND DU LAC, WI 54935
FOND DU LAC, WI 54935
Provider Phone Number
(920) 921-6800
Provider SSA County
190
Provider County Name
Fond Du Lac
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
75
Number of Residents in Certified Beds
41
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GRANCARE INC
Date First Approved to Provide Medicare and Medicaid services
1993-08-24
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
5
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
2.79634
Reported LPN Staffing Hours per Resident per Day
0.70000
Reported RN Staffing Hours per Resident per Day
0.85366
Reported Licensed Staffing Hours per Resident per Day
1.55366
Reported Total Nurse Staffing Hours per Resident per Day
4.35000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06951
Expected CNA Staffing Hours per Resident per Day
2.28306
Expected LPN Staffing Hours per Resident per Day
0.58853
Expected RN Staffing Hours per Resident per Day
0.97120
Expected Total Nurse Staffing Hours per Resident per Day
3.84280
Adjusted CNA Staffing Hours per Resident per Day
3.00534
Adjusted LPN Staffing Hours per Resident per Day
0.98720
Adjusted RN Staffing Hours per Resident per Day
0.65677
Adjusted Total Nurse Staffing Hours per Resident per Day
4.56293
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-03-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
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
2014-02-27
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2013-01-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
8.66700
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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