Lafayette Manor - Darlington Nursing Home
General Information
UPDATEFederal Provider Number
525362
Provider Name
LAFAYETTE MANOR
Provider Address
719 E CATHERINE ST BOX 167
DARLINGTON, WI 53530
DARLINGTON, WI 53530
Provider Phone Number
6087764210
Provider SSA County
320
Provider County Name
Lafayette
Ownership Type
Government - County
Number of Certified Beds
64
Number of Residents in Certified Beds
48
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTY OF LAFAYETTE
Date First Approved to Provide Medicare and Medicaid services
1984-04-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
2
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
3.02083
Reported LPN Staffing Hours per Resident per Day
0.59063
Reported RN Staffing Hours per Resident per Day
1.15417
Reported Licensed Staffing Hours per Resident per Day
1.74479
Reported Total Nurse Staffing Hours per Resident per Day
4.76563
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.48860
Expected LPN Staffing Hours per Resident per Day
0.61596
Expected RN Staffing Hours per Resident per Day
0.93600
Expected Total Nurse Staffing Hours per Resident per Day
4.04056
Adjusted CNA Staffing Hours per Resident per Day
2.97847
Adjusted LPN Staffing Hours per Resident per Day
0.79586
Adjusted RN Staffing Hours per Resident per Day
0.92136
Adjusted Total Nurse Staffing Hours per Resident per Day
4.75423
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-10-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-08-08
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
27
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
18
Cycle 3 Health Deficiency Score
464
Cycle 3 Standard Health Survey Date
2013-01-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
464
Total Weighted Health Survey Score
107.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
8
Number of Fines
8
Total Amount of Fines in Dollars
17356
Number of Payment Denials
1
Total Number of Penalties
9
Location
Processing Date
2015-06-01
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