Mayo Clinic Health System-northland, Inc - Barron Nursing Home
General Information
UPDATEFederal Provider Number
525715
Provider Name
MAYO CLINIC HEALTH SYSTEM-NORTHLAND, INC
Provider Address
1222 E WOODLAND AVE
BARRON, WI 54812
BARRON, WI 54812
Provider Phone Number
(715) 537-5322
Provider SSA County
20
Provider County Name
Barron
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
23
Number of Residents in Certified Beds
19
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
MAYO CLINIC HEALTH SYSTEM - NORTHLAND, INC.
Date First Approved to Provide Medicare and Medicaid services
2014-10-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.63947
Reported LPN Staffing Hours per Resident per Day
0.48158
Reported RN Staffing Hours per Resident per Day
1.62368
Reported Licensed Staffing Hours per Resident per Day
2.10526
Reported Total Nurse Staffing Hours per Resident per Day
5.74473
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.38611
Expected LPN Staffing Hours per Resident per Day
0.67363
Expected RN Staffing Hours per Resident per Day
0.99439
Expected Total Nurse Staffing Hours per Resident per Day
4.05414
Adjusted CNA Staffing Hours per Resident per Day
3.74256
Adjusted LPN Staffing Hours per Resident per Day
0.59337
Adjusted RN Staffing Hours per Resident per Day
1.22006
Adjusted Total Nurse Staffing Hours per Resident per Day
5.71180
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-02-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2014-04-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
6.40000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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