Northern Lights Hcc - Washburn Nursing Home
General Information
UPDATEFederal Provider Number
525567
Provider Name
NORTHERN LIGHTS HCC
Provider Address
706 BRATLEY DR
WASHBURN, WI 54891
WASHBURN, WI 54891
Provider Phone Number
7153735621
Provider SSA County
30
Provider County Name
Bayfield
Ownership Type
Non profit - Corporation
Number of Certified Beds
65
Number of Residents in Certified Beds
60
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NORTHERN LIGHTS SERVICES, INC.
Date First Approved to Provide Medicare and Medicaid services
1995-04-25
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
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.15917
Reported LPN Staffing Hours per Resident per Day
0.31167
Reported RN Staffing Hours per Resident per Day
0.77833
Reported Licensed Staffing Hours per Resident per Day
1.09000
Reported Total Nurse Staffing Hours per Resident per Day
3.24917
Reported Physical Therapist Staffing Hours per Resident Per Day
0.18583
Expected CNA Staffing Hours per Resident per Day
2.37982
Expected LPN Staffing Hours per Resident per Day
0.60047
Expected RN Staffing Hours per Resident per Day
1.02671
Expected Total Nurse Staffing Hours per Resident per Day
4.00700
Adjusted CNA Staffing Hours per Resident per Day
2.22620
Adjusted LPN Staffing Hours per Resident per Day
0.43081
Adjusted RN Staffing Hours per Resident per Day
0.56644
Adjusted Total Nurse Staffing Hours per Resident per Day
3.26855
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2015-04-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
88
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-06-04
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2013-06-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
51.33300
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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