Wisconsin Nursing Homes >> South Range Nursing Homes >> Middle River Hcc

Middle River Hcc - South Range Nursing Home

General Information

UPDATE
Federal Provider Number
525408
Provider Name
MIDDLE RIVER HCC
Provider Address
8274 E SAN RD
SOUTH RANGE, WI 54874
Provider Phone Number
7153983523
Provider SSA County
150
Provider County Name
Douglas
Ownership Type
For profit - Corporation
Number of Certified Beds
98
Number of Residents in Certified Beds
79
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MIDDLE RIVER HEALTH CARE CENTER INC
Date First Approved to Provide Medicare and Medicaid services
1987-04-01
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
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.28924
Reported LPN Staffing Hours per Resident per Day
0.66203
Reported RN Staffing Hours per Resident per Day
0.65000
Reported Licensed Staffing Hours per Resident per Day
1.31203
Reported Total Nurse Staffing Hours per Resident per Day
3.60127
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01456
Expected CNA Staffing Hours per Resident per Day
2.72136
Expected LPN Staffing Hours per Resident per Day
0.66056
Expected RN Staffing Hours per Resident per Day
1.00733
Expected Total Nurse Staffing Hours per Resident per Day
4.38925
Adjusted CNA Staffing Hours per Resident per Day
2.06408
Adjusted LPN Staffing Hours per Resident per Day
0.83185
Adjusted RN Staffing Hours per Resident per Day
0.48214
Adjusted Total Nurse Staffing Hours per Resident per Day
3.30725
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2014-11-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
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
151
Cycle 2 Standard Health Survey Date
2013-11-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-09-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
109.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
10921
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01

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