Pepin Health And Rehab - Pepin Nursing Home
General Information
UPDATEFederal Provider Number
525564
Provider Name
PEPIN HEALTH AND REHAB
Provider Address
1110 SECOND ST
PEPIN, WI 54759
PEPIN, WI 54759
Provider Phone Number
(715) 442-4811
Provider SSA County
450
Provider County Name
Pepin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1995-01-04
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
1
Health Inspection Rating Footnote
QM Rating
5
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
1.49186
Reported LPN Staffing Hours per Resident per Day
0.47326
Reported RN Staffing Hours per Resident per Day
0.89535
Reported Licensed Staffing Hours per Resident per Day
1.36860
Reported Total Nurse Staffing Hours per Resident per Day
2.86047
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02674
Expected CNA Staffing Hours per Resident per Day
2.14643
Expected LPN Staffing Hours per Resident per Day
0.60795
Expected RN Staffing Hours per Resident per Day
1.09260
Expected Total Nurse Staffing Hours per Resident per Day
3.84698
Adjusted CNA Staffing Hours per Resident per Day
1.70543
Adjusted LPN Staffing Hours per Resident per Day
0.64611
Adjusted RN Staffing Hours per Resident per Day
0.61231
Adjusted Total Nurse Staffing Hours per Resident per Day
2.99723
Cycle 1 Total Number of Health Deficiencies
17
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2014-07-10
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
22
Cycle 2 Number of Standard Health Deficiencies
18
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
116
Cycle 2 Standard Health Survey Date
2013-07-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
116
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-06-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
86.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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