Lake Terrace Health And Rehabilitation Center - Milwaukee Nursing Home
General Information
UPDATEFederal Provider Number
525319
Provider Name
LAKE TERRACE HEALTH AND REHABILITATION CENTER
Provider Address
2115 E WOODSTOCK PL
MILWAUKEE, WI 53202
MILWAUKEE, WI 53202
Provider Phone Number
4142711020
Provider SSA County
390
Provider County Name
Milwaukee
Ownership Type
For profit - Corporation
Number of Certified Beds
196
Number of Residents in Certified Beds
131
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EASTSIDE OPERATING COMPANY LLC
Date First Approved to Provide Medicare and Medicaid services
1982-01-01
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
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
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
2.32863
Reported LPN Staffing Hours per Resident per Day
0.74924
Reported RN Staffing Hours per Resident per Day
0.69656
Reported Licensed Staffing Hours per Resident per Day
1.44580
Reported Total Nurse Staffing Hours per Resident per Day
3.77443
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03282
Expected CNA Staffing Hours per Resident per Day
2.40692
Expected LPN Staffing Hours per Resident per Day
0.67528
Expected RN Staffing Hours per Resident per Day
1.05261
Expected Total Nurse Staffing Hours per Resident per Day
4.13482
Adjusted CNA Staffing Hours per Resident per Day
2.37388
Adjusted LPN Staffing Hours per Resident per Day
0.92090
Adjusted RN Staffing Hours per Resident per Day
0.49446
Adjusted Total Nurse Staffing Hours per Resident per Day
3.67957
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-12-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
10
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2014-07-17
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
19
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
19
Cycle 3 Health Deficiency Score
237
Cycle 3 Standard Health Survey Date
2014-01-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
237
Total Weighted Health Survey Score
66.83300
Number of Facility Reported Incidents
15
Number of Substantiated Complaints
19
Number of Fines
2
Total Amount of Fines in Dollars
19500
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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