Gray's Nursing Home - Platteville Nursing Home

General Information

UPDATE
Federal Provider Number
525530
Provider Name
GRAY'S NURSING HOME
Provider Address
555 N CHESTNUT ST
PLATTEVILLE, WI 53818
Provider Phone Number
6083496741
Provider SSA County
210
Provider County Name
Grant
Ownership Type
For profit - Corporation
Number of Certified Beds
20
Number of Residents in Certified Beds
17
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GRAY'S NURSING HOME, INC
Date First Approved to Provide Medicare and Medicaid services
1994-03-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
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
2.91176
Reported LPN Staffing Hours per Resident per Day
0.94118
Reported RN Staffing Hours per Resident per Day
0.86765
Reported Licensed Staffing Hours per Resident per Day
1.80882
Reported Total Nurse Staffing Hours per Resident per Day
4.72059
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08529
Expected CNA Staffing Hours per Resident per Day
2.52981
Expected LPN Staffing Hours per Resident per Day
0.60461
Expected RN Staffing Hours per Resident per Day
0.90135
Expected Total Nurse Staffing Hours per Resident per Day
4.03577
Adjusted CNA Staffing Hours per Resident per Day
2.82416
Adjusted LPN Staffing Hours per Resident per Day
1.29205
Adjusted RN Staffing Hours per Resident per Day
0.71926
Adjusted Total Nurse Staffing Hours per Resident per Day
4.71489
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
237
Cycle 1 Standard Survey Health Date
2015-03-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
237
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2014-05-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2013-04-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
139.83300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
3
Total Amount of Fines in Dollars
6501
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01

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