Mellen Manor - Mellen Nursing Home
General Information
UPDATEFederal Provider Number
525697
Provider Name
MELLEN MANOR
Provider Address
450 LAKE DR
MELLEN, WI 54546
MELLEN, WI 54546
Provider Phone Number
(715) 274-5706
Provider SSA County
10
Provider County Name
Ashland
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
34
Number of Residents in Certified Beds
27
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PREISLER-LYNN, LLP
Date First Approved to Provide Medicare and Medicaid services
2009-03-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
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
1.77037
Reported LPN Staffing Hours per Resident per Day
0.30000
Reported RN Staffing Hours per Resident per Day
0.99630
Reported Licensed Staffing Hours per Resident per Day
1.29630
Reported Total Nurse Staffing Hours per Resident per Day
3.06667
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.51089
Expected LPN Staffing Hours per Resident per Day
0.57579
Expected RN Staffing Hours per Resident per Day
0.81565
Expected Total Nurse Staffing Hours per Resident per Day
3.90233
Adjusted CNA Staffing Hours per Resident per Day
1.73005
Adjusted LPN Staffing Hours per Resident per Day
0.43245
Adjusted RN Staffing Hours per Resident per Day
0.91269
Adjusted Total Nurse Staffing Hours per Resident per Day
3.16771
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-02-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
116
Cycle 2 Standard Health Survey Date
2014-02-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
116
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2013-05-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
64.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
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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