Maplewood Of Sauk Prairie - Sauk City Nursing Home
General Information
UPDATEFederal Provider Number
525462
Provider Name
MAPLEWOOD OF SAUK PRAIRIE
Provider Address
245 SYCAMORE ST
SAUK CITY, WI 53583
SAUK CITY, WI 53583
Provider Phone Number
(608) 643-3383
Provider SSA County
550
Provider County Name
Sauk
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
115
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NURSING HOMES INC.
Date First Approved to Provide Medicare and Medicaid services
1990-01-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.83826
Reported LPN Staffing Hours per Resident per Day
0.50435
Reported RN Staffing Hours per Resident per Day
0.51696
Reported Licensed Staffing Hours per Resident per Day
1.02130
Reported Total Nurse Staffing Hours per Resident per Day
3.85957
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07826
Expected CNA Staffing Hours per Resident per Day
2.73639
Expected LPN Staffing Hours per Resident per Day
0.64955
Expected RN Staffing Hours per Resident per Day
1.00272
Expected Total Nurse Staffing Hours per Resident per Day
4.38866
Adjusted CNA Staffing Hours per Resident per Day
2.54505
Adjusted LPN Staffing Hours per Resident per Day
0.64446
Adjusted RN Staffing Hours per Resident per Day
0.38523
Adjusted Total Nurse Staffing Hours per Resident per Day
3.54494
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-10-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-07-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2012-06-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
40.00000
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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