Lakeland Health Care Ctr - Elkhorn Nursing Home
General Information
UPDATEFederal Provider Number
525625
Provider Name
LAKELAND HEALTH CARE CTR
Provider Address
1922 CTY RD NN
ELKHORN, WI 53121
ELKHORN, WI 53121
Provider Phone Number
(262) 741-3600
Provider SSA County
630
Provider County Name
Walworth
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
120
Number of Residents in Certified Beds
117
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTY OF WALWORTH
Date First Approved to Provide Medicare and Medicaid services
1997-08-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
4.37051
Reported LPN Staffing Hours per Resident per Day
0.44786
Reported RN Staffing Hours per Resident per Day
0.63291
Reported Licensed Staffing Hours per Resident per Day
1.08077
Reported Total Nurse Staffing Hours per Resident per Day
5.45128
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03846
Expected CNA Staffing Hours per Resident per Day
2.53027
Expected LPN Staffing Hours per Resident per Day
0.60369
Expected RN Staffing Hours per Resident per Day
0.92091
Expected Total Nurse Staffing Hours per Resident per Day
4.05488
Adjusted CNA Staffing Hours per Resident per Day
4.23825
Adjusted LPN Staffing Hours per Resident per Day
0.61575
Adjusted RN Staffing Hours per Resident per Day
0.51353
Adjusted Total Nurse Staffing Hours per Resident per Day
5.41905
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-02-19
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-01-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2011-12-02
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
13.33300
Number of Facility Reported Incidents
3
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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