Pine Crest Nursing Home - Merrill Nursing Home
General Information
UPDATEFederal Provider Number
525326
Provider Name
PINE CREST NURSING HOME
Provider Address
2100 E SIXTH ST
MERRILL, WI 54452
MERRILL, WI 54452
Provider Phone Number
(715) 536-0355
Provider SSA County
340
Provider County Name
Lincoln
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
180
Number of Residents in Certified Beds
170
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTY OF LINCOLN
Date First Approved to Provide Medicare and Medicaid services
1983-01-19
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
2
QM Rating Footnote
Staffing Rating
4
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
2.34529
Reported LPN Staffing Hours per Resident per Day
0.19647
Reported RN Staffing Hours per Resident per Day
1.00882
Reported Licensed Staffing Hours per Resident per Day
1.20529
Reported Total Nurse Staffing Hours per Resident per Day
3.55058
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04412
Expected CNA Staffing Hours per Resident per Day
2.27117
Expected LPN Staffing Hours per Resident per Day
0.58182
Expected RN Staffing Hours per Resident per Day
0.87297
Expected Total Nurse Staffing Hours per Resident per Day
3.72596
Adjusted CNA Staffing Hours per Resident per Day
2.53378
Adjusted LPN Staffing Hours per Resident per Day
0.28027
Adjusted RN Staffing Hours per Resident per Day
0.86348
Adjusted Total Nurse Staffing Hours per Resident per Day
3.84117
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2014-10-09
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
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-10-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-10-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
58.00000
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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