Mulder Health Care Facility - West Salem Nursing Home
General Information
UPDATEFederal Provider Number
525209
Provider Name
MULDER HEALTH CARE FACILITY
Provider Address
713 N LEONARD ST PO BOX 850
WEST SALEM, WI 54669
WEST SALEM, WI 54669
Provider Phone Number
(608) 786-1600
Provider SSA County
310
Provider County Name
La Crosse
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
93
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MULDER HEALTH CARE FACILITY, INC
Date First Approved to Provide Medicare and Medicaid services
1968-11-11
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
3
Overall Rating Footnote
Health Inspection Rating
2
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
2.77133
Reported LPN Staffing Hours per Resident per Day
0.64467
Reported RN Staffing Hours per Resident per Day
0.89867
Reported Licensed Staffing Hours per Resident per Day
1.54333
Reported Total Nurse Staffing Hours per Resident per Day
4.31467
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04933
Expected CNA Staffing Hours per Resident per Day
2.28507
Expected LPN Staffing Hours per Resident per Day
0.58095
Expected RN Staffing Hours per Resident per Day
0.90555
Expected Total Nurse Staffing Hours per Resident per Day
3.77157
Adjusted CNA Staffing Hours per Resident per Day
2.97584
Adjusted LPN Staffing Hours per Resident per Day
0.92104
Adjusted RN Staffing Hours per Resident per Day
0.74152
Adjusted Total Nurse Staffing Hours per Resident per Day
4.61134
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-12-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-11-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-09-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
52.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
11115
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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