Mercy Manor Trans Ctr - Janesville Nursing Home
General Information
UPDATEFederal Provider Number
525666
Provider Name
MERCY MANOR TRANS CTR
Provider Address
1000 MINERAL POINT AVE PO BOX 5003
JANESVILLE, WI 53547
JANESVILLE, WI 53547
Provider Phone Number
(608) 756-6050
Provider SSA County
520
Provider County Name
Rock
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
28
Number of Residents in Certified Beds
21
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
MERCY HEALTH SYSTEM CORPORATION
Date First Approved to Provide Medicare and Medicaid services
2003-01-31
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
4
Health Inspection Rating Footnote
QM Rating
4
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
3.40238
Reported LPN Staffing Hours per Resident per Day
0.15952
Reported RN Staffing Hours per Resident per Day
2.51429
Reported Licensed Staffing Hours per Resident per Day
2.67381
Reported Total Nurse Staffing Hours per Resident per Day
6.07619
Reported Physical Therapist Staffing Hours per Resident Per Day
0.35000
Expected CNA Staffing Hours per Resident per Day
2.39373
Expected LPN Staffing Hours per Resident per Day
0.83359
Expected RN Staffing Hours per Resident per Day
1.83055
Expected Total Nurse Staffing Hours per Resident per Day
5.05787
Adjusted CNA Staffing Hours per Resident per Day
3.48762
Adjusted LPN Staffing Hours per Resident per Day
0.15883
Adjusted RN Staffing Hours per Resident per Day
1.02629
Adjusted Total Nurse Staffing Hours per Resident per Day
4.84245
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-07-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-06-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-04-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
26.00000
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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