Kenosha Estates Rehab And Care Center - Kenosha Nursing Home
General Information
UPDATEFederal Provider Number
525125
Provider Name
KENOSHA ESTATES REHAB AND CARE CENTER
Provider Address
1703 60TH ST
KENOSHA, WI 53140
KENOSHA, WI 53140
Provider Phone Number
(262) 658-4125
Provider SSA County
290
Provider County Name
Kenosha
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
97
Number of Residents in Certified Beds
84
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1967-01-09
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
1
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.91012
Reported LPN Staffing Hours per Resident per Day
0.25833
Reported RN Staffing Hours per Resident per Day
0.55774
Reported Licensed Staffing Hours per Resident per Day
0.81607
Reported Total Nurse Staffing Hours per Resident per Day
2.72619
Reported Physical Therapist Staffing Hours per Resident Per Day
0.18274
Expected CNA Staffing Hours per Resident per Day
2.34231
Expected LPN Staffing Hours per Resident per Day
0.63104
Expected RN Staffing Hours per Resident per Day
1.03695
Expected Total Nurse Staffing Hours per Resident per Day
4.01030
Adjusted CNA Staffing Hours per Resident per Day
2.00096
Adjusted LPN Staffing Hours per Resident per Day
0.33978
Adjusted RN Staffing Hours per Resident per Day
0.40189
Adjusted Total Nurse Staffing Hours per Resident per Day
2.74020
Cycle 1 Total Number of Health Deficiencies
21
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
17
Cycle 1 Health Deficiency Score
774
Cycle 1 Standard Survey Health Date
2014-03-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
774
Cycle 2 Total Number of Health Deficiencies
16
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
116
Cycle 2 Standard Health Survey Date
2012-12-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
116
Cycle 3 Total Number of Health Deficiencies
22
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
15
Cycle 3 Health Deficiency Score
112
Cycle 3 Standard Health Survey Date
2011-10-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
112
Total Weighted Health Survey Score
444.33300
Number of Facility Reported Incidents
11
Number of Substantiated Complaints
14
Number of Fines
2
Total Amount of Fines in Dollars
52455
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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