Lake Country Health And Rehab Center - Oconomowoc Nursing Home

General Information

UPDATE

Federal Provider Number

525702

Provider Name

LAKE COUNTRY HEALTH AND REHAB CENTER

Provider Address

2195 NORTH SUMMIT VILLAGE WAY
OCONOMOWOC, WI 53066

Provider Phone Number

(262) 567-4662

Provider SSA County

660

Provider County Name

Waukesha

Provider Website

Provider Description

Ownership Type

For profit - Corporation

Number of Certified Beds

100

Number of Residents in Certified Beds

Provider Type

Medicare and Medicaid

Provider Resides in Hospital

Legal Business Name

EHF LAKE COUNTRY SNF OP, LLC

Date First Approved to Provide Medicare and Medicaid services

2009-11-23

Continuing Care Retirement Community

Special Focus Facility

Provider Changed Ownership in Last 12 Months

With a Resident and Family Council

Resident

Automatic Sprinkler Systems in All Required Areas

Yes

Rating Detail Information

Overall Rating

Overall Rating Footnote

Health Inspection Rating

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QM Rating

QM Rating Footnote

Staffing Rating

Staffing Rating Footnote

RN Staffing Rating

RN Staffing Rating Footnote

Reported Staffing Footnote

Physical Therapist Staffing Footnote

Reported CNA Staffing Hours per Resident per Day

2.62586

Reported LPN Staffing Hours per Resident per Day

0.63391

Reported RN Staffing Hours per Resident per Day

1.38218

Reported Licensed Staffing Hours per Resident per Day

2.01609

Reported Total Nurse Staffing Hours per Resident per Day

4.64195

Reported Physical Therapist Staffing Hours per Resident Per Day

0.14943

Expected CNA Staffing Hours per Resident per Day

2.58751

Expected LPN Staffing Hours per Resident per Day

0.70645

Expected RN Staffing Hours per Resident per Day

1.27101

Expected Total Nurse Staffing Hours per Resident per Day

4.56497

Adjusted CNA Staffing Hours per Resident per Day

2.49007

Adjusted LPN Staffing Hours per Resident per Day

0.74477

Adjusted RN Staffing Hours per Resident per Day

0.81255

Adjusted Total Nurse Staffing Hours per Resident per Day

4.09887

Cycle 1 Total Number of Health Deficiencies

Cycle 1 Number of Standard Health Deficiencies

Cycle 1 Number of Complaint Health Deficiencies

Cycle 1 Health Deficiency Score

Cycle 1 Standard Survey Health Date

2014-01-29

Cycle 1 Number of Health Revisits

Cycle 1 Health Revisit Score

Cycle 1 Total Health Score

Cycle 2 Total Number of Health Deficiencies

Cycle 2 Number of Standard Health Deficiencies

Cycle 2 Number of Complaint Health Deficiencies

Cycle 2 Health Deficiency Score

Cycle 2 Standard Health Survey Date

2012-11-05

Cycle 2 Number of Health Revisits

Cycle 2 Health Revisit Score

Cycle 2 Total Health Score

Cycle 3 Total Number of Health Deficiencies

Cycle 3 Number of Standard Health Deficiencies

Cycle 3 Number of Complaint Health Deficiencies

Cycle 3 Health Deficiency Score

Cycle 3 Standard Health Survey Date

2011-09-27

Cycle 3 Number of Health Revisits

Cycle 3 Health Revisit Score

Cycle 3 Total Health Score

Total Weighted Health Survey Score

8.00000

Number of Facility Reported Incidents

Number of Substantiated Complaints

Number of Fines

Total Amount of Fines in Dollars

Number of Payment Denials

Total Number of Penalties

Location

Processing Date

2015-06-01

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