Knapp Haven Nursing Home - Chetek Nursing Home
General Information
UPDATEFederal Provider Number
525672
Provider Name
KNAPP HAVEN NURSING HOME
Provider Address
725 KNAPP ST
CHETEK, WI 54728
CHETEK, WI 54728
Provider Phone Number
(715) 924-4891
Provider SSA County
20
Provider County Name
Barron
Provider Website
Provider Description
Ownership Type
Government - City
Number of Certified Beds
97
Number of Residents in Certified Beds
85
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CITY OF CHETEK
Date First Approved to Provide Medicare and Medicaid services
2004-05-10
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
4
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.75294
Reported LPN Staffing Hours per Resident per Day
0.31176
Reported RN Staffing Hours per Resident per Day
0.88176
Reported Licensed Staffing Hours per Resident per Day
1.19353
Reported Total Nurse Staffing Hours per Resident per Day
3.94646
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.49359
Expected LPN Staffing Hours per Resident per Day
0.56698
Expected RN Staffing Hours per Resident per Day
0.79902
Expected Total Nurse Staffing Hours per Resident per Day
3.85959
Adjusted CNA Staffing Hours per Resident per Day
2.70890
Adjusted LPN Staffing Hours per Resident per Day
0.45639
Adjusted RN Staffing Hours per Resident per Day
0.82458
Adjusted Total Nurse Staffing Hours per Resident per Day
4.12163
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2014-10-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
88
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-09-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-09-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
63.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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