Pavilion At Glacier Valley - Slinger Nursing Home
General Information
UPDATEFederal Provider Number
525461
Provider Name
PAVILION AT GLACIER VALLEY
Provider Address
1900 AMERICAN EAGLE DR
SLINGER, WI 53086
SLINGER, WI 53086
Provider Phone Number
(262) 297-6300
Provider SSA County
650
Provider County Name
Washington
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
106
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THI OF WISCONSIN AT HARTFORD, LLC
Date First Approved to Provide Medicare and Medicaid services
1989-11-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
1.76545
Reported LPN Staffing Hours per Resident per Day
0.68727
Reported RN Staffing Hours per Resident per Day
1.12364
Reported Licensed Staffing Hours per Resident per Day
1.81091
Reported Total Nurse Staffing Hours per Resident per Day
3.57636
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10273
Expected CNA Staffing Hours per Resident per Day
2.59313
Expected LPN Staffing Hours per Resident per Day
0.71685
Expected RN Staffing Hours per Resident per Day
1.25451
Expected Total Nurse Staffing Hours per Resident per Day
4.56450
Adjusted CNA Staffing Hours per Resident per Day
1.67052
Adjusted LPN Staffing Hours per Resident per Day
0.79575
Adjusted RN Staffing Hours per Resident per Day
0.66925
Adjusted Total Nurse Staffing Hours per Resident per Day
3.15827
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-08-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
14
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
104
Cycle 2 Standard Health Survey Date
2013-08-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
104
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
2012-05-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
54.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
20475
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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