Maple Ridge Care Center - Spooner Nursing Home
General Information
UPDATEFederal Provider Number
525673
Provider Name
MAPLE RIDGE CARE CENTER
Provider Address
510 FIRST ST
SPOONER, WI 54801
SPOONER, WI 54801
Provider Phone Number
(715) 635-1412
Provider SSA County
640
Provider County Name
Washburn
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
75
Number of Residents in Certified Beds
69
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BENEDICTINE LIVING COMMUNITY OF SPOONER
Date First Approved to Provide Medicare and Medicaid services
2004-05-15
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
1
Health Inspection Rating Footnote
QM Rating
2
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
2.35362
Reported LPN Staffing Hours per Resident per Day
0.38623
Reported RN Staffing Hours per Resident per Day
0.75652
Reported Licensed Staffing Hours per Resident per Day
1.14275
Reported Total Nurse Staffing Hours per Resident per Day
3.49637
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02609
Expected CNA Staffing Hours per Resident per Day
2.60259
Expected LPN Staffing Hours per Resident per Day
0.56307
Expected RN Staffing Hours per Resident per Day
0.80968
Expected Total Nurse Staffing Hours per Resident per Day
3.97535
Adjusted CNA Staffing Hours per Resident per Day
2.21897
Adjusted LPN Staffing Hours per Resident per Day
0.56933
Adjusted RN Staffing Hours per Resident per Day
0.69814
Adjusted Total Nurse Staffing Hours per Resident per Day
3.54523
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-04-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
17
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
136
Cycle 2 Standard Health Survey Date
2013-03-04
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
136
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
104
Cycle 3 Standard Health Survey Date
2012-01-25
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
52
Cycle 3 Total Health Score
156
Total Weighted Health Survey Score
89.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
18000
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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