Manorcare Health Services - Appleton Nursing Home
General Information
UPDATEFederal Provider Number
525264
Provider Name
MANORCARE HEALTH SERVICES
Provider Address
1335 S ONEIDA ST
APPLETON, WI 54915
APPLETON, WI 54915
Provider Phone Number
(920) 731-6646
Provider SSA County
430
Provider County Name
Outagamie
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
104
Number of Residents in Certified Beds
68
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MANORCARE HEALTH SERVICES LLC
Date First Approved to Provide Medicare and Medicaid services
1975-03-14
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.88750
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
1.02794
Reported Licensed Staffing Hours per Resident per Day
1.02794
Reported Total Nurse Staffing Hours per Resident per Day
3.91544
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05735
Expected CNA Staffing Hours per Resident per Day
2.61951
Expected LPN Staffing Hours per Resident per Day
0.75036
Expected RN Staffing Hours per Resident per Day
1.24754
Expected Total Nurse Staffing Hours per Resident per Day
4.61741
Adjusted CNA Staffing Hours per Resident per Day
2.70473
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.61567
Adjusted Total Nurse Staffing Hours per Resident per Day
3.41810
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-09-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-07-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-06-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
35.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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