Park View Home - Woodville Nursing Home
General Information
UPDATEFederal Provider Number
525458
Provider Name
PARK VIEW HOME
Provider Address
220 LOCKWOOD ST
WOODVILLE, WI 54028
WOODVILLE, WI 54028
Provider Phone Number
(715) 698-2451
Provider SSA County
540
Provider County Name
St. Croix
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
48
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PARK VIEW HOME, INC.
Date First Approved to Provide Medicare and Medicaid services
1990-01-01
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
2.73854
Reported LPN Staffing Hours per Resident per Day
0.48750
Reported RN Staffing Hours per Resident per Day
0.67500
Reported Licensed Staffing Hours per Resident per Day
1.16250
Reported Total Nurse Staffing Hours per Resident per Day
3.90104
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.59607
Expected LPN Staffing Hours per Resident per Day
0.60601
Expected RN Staffing Hours per Resident per Day
0.96102
Expected Total Nurse Staffing Hours per Resident per Day
4.16310
Adjusted CNA Staffing Hours per Resident per Day
2.58835
Adjusted LPN Staffing Hours per Resident per Day
0.66769
Adjusted RN Staffing Hours per Resident per Day
0.52482
Adjusted Total Nurse Staffing Hours per Resident per Day
3.77716
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-12-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2014-02-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2013-01-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
36.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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