Wisconsin Nursing Homes >> Whitehall Nursing Homes >> Gundersen Tri-county Care Center

Gundersen Tri-county Care Center - Whitehall Nursing Home

General Information

UPDATE
Federal Provider Number
525679
Provider Name
GUNDERSEN TRI-COUNTY CARE CENTER
Provider Address
18601 LINCOLN ST
WHITEHALL, WI 54773
Provider Phone Number
(715) 538-4361
Provider SSA County
600
Provider County Name
Trempealeau
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
35
Number of Residents in Certified Beds
32
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
TRI-COUNTY MEMORIAL HOSPITAL, INC.
Date First Approved to Provide Medicare and Medicaid services
2004-08-24
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
4
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
2.49219
Reported LPN Staffing Hours per Resident per Day
0.57969
Reported RN Staffing Hours per Resident per Day
0.76563
Reported Licensed Staffing Hours per Resident per Day
1.34531
Reported Total Nurse Staffing Hours per Resident per Day
3.83751
Reported Physical Therapist Staffing Hours per Resident Per Day
0.85469
Expected CNA Staffing Hours per Resident per Day
2.46320
Expected LPN Staffing Hours per Resident per Day
0.59185
Expected RN Staffing Hours per Resident per Day
0.82985
Expected Total Nurse Staffing Hours per Resident per Day
3.88490
Adjusted CNA Staffing Hours per Resident per Day
2.48257
Adjusted LPN Staffing Hours per Resident per Day
0.81295
Adjusted RN Staffing Hours per Resident per Day
0.68937
Adjusted Total Nurse Staffing Hours per Resident per Day
3.98172
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-03-24
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
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2014-05-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
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
2013-07-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
17.33300
Number of Facility Reported Incidents
1
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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