Luther Manor - Milwaukee Nursing Home
General Information
UPDATEFederal Provider Number
525588
Provider Name
LUTHER MANOR
Provider Address
4545 N 92ND ST
MILWAUKEE, WI 53225
MILWAUKEE, WI 53225
Provider Phone Number
(414) 464-3880
Provider SSA County
390
Provider County Name
Milwaukee
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
210
Number of Residents in Certified Beds
198
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
UNITED LUTHERAN PROGRAM FOR THE AGING, INC
Date First Approved to Provide Medicare and Medicaid services
1996-05-01
Continuing Care Retirement Community
Y
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
3
Health Inspection Rating Footnote
QM Rating
3
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
2.74242
Reported LPN Staffing Hours per Resident per Day
0.38535
Reported RN Staffing Hours per Resident per Day
0.96970
Reported Licensed Staffing Hours per Resident per Day
1.35505
Reported Total Nurse Staffing Hours per Resident per Day
4.09747
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10177
Expected CNA Staffing Hours per Resident per Day
2.60012
Expected LPN Staffing Hours per Resident per Day
0.61189
Expected RN Staffing Hours per Resident per Day
0.94731
Expected Total Nurse Staffing Hours per Resident per Day
4.15933
Adjusted CNA Staffing Hours per Resident per Day
2.58798
Adjusted LPN Staffing Hours per Resident per Day
0.52271
Adjusted RN Staffing Hours per Resident per Day
0.76486
Adjusted Total Nurse Staffing Hours per Resident per Day
3.97095
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-11-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
17
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2013-10-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
88
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-06-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
34.66700
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
5
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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