Marquardt Memorial Manor - Watertown Nursing Home

General Information

UPDATE
Federal Provider Number
525543
Provider Name
MARQUARDT MEMORIAL MANOR
Provider Address
1020 HILL ST
WATERTOWN, WI 53098
Provider Phone Number
(920) 261-0400
Provider SSA County
130
Provider County Name
Dodge
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
140
Number of Residents in Certified Beds
110
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MARQUARDT MEMORIAL MANOR, INC.
Date First Approved to Provide Medicare and Medicaid services
1994-08-01
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
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
2.81864
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
0.77273
Reported Licensed Staffing Hours per Resident per Day
0.77273
Reported Total Nurse Staffing Hours per Resident per Day
3.59137
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05182
Expected CNA Staffing Hours per Resident per Day
2.59355
Expected LPN Staffing Hours per Resident per Day
0.65909
Expected RN Staffing Hours per Resident per Day
0.99082
Expected Total Nurse Staffing Hours per Resident per Day
4.24346
Adjusted CNA Staffing Hours per Resident per Day
2.66665
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.58273
Adjusted Total Nurse Staffing Hours per Resident per Day
3.41147
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
94
Cycle 1 Standard Survey Health Date
2014-11-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
94
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2013-09-12
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
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
193
Cycle 3 Standard Health Survey Date
2012-06-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
193
Total Weighted Health Survey Score
108.50000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
3
Number of Fines
3
Total Amount of Fines in Dollars
15958
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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