Plum City Care Ctr - Plum City Nursing Home

General Information

UPDATE
Federal Provider Number
525440
Provider Name
PLUM CITY CARE CTR
Provider Address
301 CHERRY AVENUE WEST
PLUM CITY, WI 54761
Provider Phone Number
(715) 647-2401
Provider SSA County
460
Provider County Name
Pierce
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
28
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PLUM CITY CARE CENTER, INC.
Date First Approved to Provide Medicare and Medicaid services
1989-10-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
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
2.54107
Reported LPN Staffing Hours per Resident per Day
0.48750
Reported RN Staffing Hours per Resident per Day
0.86786
Reported Licensed Staffing Hours per Resident per Day
1.35536
Reported Total Nurse Staffing Hours per Resident per Day
3.89643
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04286
Expected CNA Staffing Hours per Resident per Day
2.60966
Expected LPN Staffing Hours per Resident per Day
0.71881
Expected RN Staffing Hours per Resident per Day
1.03194
Expected Total Nurse Staffing Hours per Resident per Day
4.36041
Adjusted CNA Staffing Hours per Resident per Day
2.38921
Adjusted LPN Staffing Hours per Resident per Day
0.56291
Adjusted RN Staffing Hours per Resident per Day
0.62840
Adjusted Total Nurse Staffing Hours per Resident per Day
3.60198
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-08-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-08-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-11-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
22.00000
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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