Manorcare Health Services-kenosha - Kenosha Nursing Home
General Information
UPDATEFederal Provider Number
525179
Provider Name
MANORCARE HEALTH SERVICES-KENOSHA
Provider Address
3100 WASHINGTON RD
KENOSHA, WI 53144
KENOSHA, WI 53144
Provider Phone Number
(262) 658-4622
Provider SSA County
290
Provider County Name
Kenosha
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
153
Number of Residents in Certified Beds
105
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HEARTLAND-WASHINGTON MANOR OF KENOSHA WI LLC
Date First Approved to Provide Medicare and Medicaid services
1969-04-14
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
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
2.09381
Reported LPN Staffing Hours per Resident per Day
0.62905
Reported RN Staffing Hours per Resident per Day
0.71571
Reported Licensed Staffing Hours per Resident per Day
1.34476
Reported Total Nurse Staffing Hours per Resident per Day
3.43857
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09857
Expected CNA Staffing Hours per Resident per Day
2.49768
Expected LPN Staffing Hours per Resident per Day
0.67914
Expected RN Staffing Hours per Resident per Day
1.12544
Expected Total Nurse Staffing Hours per Resident per Day
4.30225
Adjusted CNA Staffing Hours per Resident per Day
2.05694
Adjusted LPN Staffing Hours per Resident per Day
0.76879
Adjusted RN Staffing Hours per Resident per Day
0.47517
Adjusted Total Nurse Staffing Hours per Resident per Day
3.22169
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-09-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-08-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-05-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
30.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
4
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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