Premier Rehab And Skilled Nursing - Beloit Nursing Home
General Information
UPDATEFederal Provider Number
525663
Provider Name
PREMIER REHAB AND SKILLED NURSING
Provider Address
2121 PIONEER DR
BELOIT, WI 53511
BELOIT, WI 53511
Provider Phone Number
(608) 365-9526
Provider SSA County
520
Provider County Name
Rock
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
95
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LJ III HEALTH MANAGEMENT INC.
Date First Approved to Provide Medicare and Medicaid services
2001-07-12
Continuing Care Retirement Community
N
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
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
2.50316
Reported LPN Staffing Hours per Resident per Day
0.59368
Reported RN Staffing Hours per Resident per Day
0.90684
Reported Licensed Staffing Hours per Resident per Day
1.50053
Reported Total Nurse Staffing Hours per Resident per Day
4.00368
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09474
Expected CNA Staffing Hours per Resident per Day
2.32927
Expected LPN Staffing Hours per Resident per Day
0.60125
Expected RN Staffing Hours per Resident per Day
0.95325
Expected Total Nurse Staffing Hours per Resident per Day
3.88377
Adjusted CNA Staffing Hours per Resident per Day
2.63688
Adjusted LPN Staffing Hours per Resident per Day
0.81955
Adjusted RN Staffing Hours per Resident per Day
0.71082
Adjusted Total Nurse Staffing Hours per Resident per Day
4.15535
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-04-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
96
Cycle 2 Standard Health Survey Date
2013-02-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
96
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2011-11-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
80.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
2
Total Amount of Fines in Dollars
11505
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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