Menomonee Falls Hcc - Menomonee Falls Nursing Home

General Information

UPDATE

Federal Provider Number

525415

Provider Name

MENOMONEE FALLS HCC

Provider Address

N84 W17049 MENOMONEE AVE
MENOMONEE FALLS, WI 53051

Provider Phone Number

(262) 255-1180

Provider SSA County

660

Provider County Name

Waukesha

Provider Website

Provider Description

Ownership Type

For profit - Corporation

Number of Certified Beds

100

Number of Residents in Certified Beds

Provider Type

Medicare and Medicaid

Provider Resides in Hospital

Legal Business Name

EXTENDICARE HOMES, INC

Date First Approved to Provide Medicare and Medicaid services

1988-08-11

Continuing Care Retirement Community

Special Focus Facility

Provider Changed Ownership in Last 12 Months

With a Resident and Family Council

Resident

Automatic Sprinkler Systems in All Required Areas

Yes

Rating Detail Information

Overall Rating

Overall Rating Footnote

Health Inspection Rating

Health Inspection Rating Footnote

QM Rating

QM Rating Footnote

Staffing Rating

Staffing Rating Footnote

RN Staffing Rating

RN Staffing Rating Footnote

Reported Staffing Footnote

Physical Therapist Staffing Footnote

Reported CNA Staffing Hours per Resident per Day

2.18056

Reported LPN Staffing Hours per Resident per Day

0.82500

Reported RN Staffing Hours per Resident per Day

1.29537

Reported Licensed Staffing Hours per Resident per Day

2.12037

Reported Total Nurse Staffing Hours per Resident per Day

4.30093

Reported Physical Therapist Staffing Hours per Resident Per Day

0.14815

Expected CNA Staffing Hours per Resident per Day

2.35845

Expected LPN Staffing Hours per Resident per Day

0.64994

Expected RN Staffing Hours per Resident per Day

1.14649

Expected Total Nurse Staffing Hours per Resident per Day

4.15487

Adjusted CNA Staffing Hours per Resident per Day

2.26863

Adjusted LPN Staffing Hours per Resident per Day

1.05356

Adjusted RN Staffing Hours per Resident per Day

0.84423

Adjusted Total Nurse Staffing Hours per Resident per Day

4.17260

Cycle 1 Total Number of Health Deficiencies

Cycle 1 Number of Standard Health Deficiencies

Cycle 1 Number of Complaint Health Deficiencies

Cycle 1 Health Deficiency Score

601

Cycle 1 Standard Survey Health Date

2014-12-08

Cycle 1 Number of Health Revisits

Cycle 1 Health Revisit Score

Cycle 1 Total Health Score

601

Cycle 2 Total Number of Health Deficiencies

Cycle 2 Number of Standard Health Deficiencies

Cycle 2 Number of Complaint Health Deficiencies

Cycle 2 Health Deficiency Score

Cycle 2 Standard Health Survey Date

2013-10-03

Cycle 2 Number of Health Revisits

Cycle 2 Health Revisit Score

Cycle 2 Total Health Score

Cycle 3 Total Number of Health Deficiencies

Cycle 3 Number of Standard Health Deficiencies

Cycle 3 Number of Complaint Health Deficiencies

Cycle 3 Health Deficiency Score

140

Cycle 3 Standard Health Survey Date

2012-08-16

Cycle 3 Number of Health Revisits

Cycle 3 Health Revisit Score

Cycle 3 Total Health Score

140

Total Weighted Health Survey Score

346.50000

Number of Facility Reported Incidents

Number of Substantiated Complaints

Number of Fines

Total Amount of Fines in Dollars

156228

Number of Payment Denials

Total Number of Penalties

Location

Processing Date

2015-06-01

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