Rest Haven Health Care Center - Verona Nursing Home

General Information

UPDATE
Federal Provider Number
525485
Provider Name
REST HAVEN HEALTH CARE CENTER
Provider Address
7672 W MINERAL POINT RD
VERONA, WI 53593
Provider Phone Number
6088331691
Provider SSA County
120
Provider County Name
Dane
Ownership Type
For profit - Individual
Number of Certified Beds
21
Number of Residents in Certified Beds
17
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
REST HAVEN HEALTH CARE CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
1992-04-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
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
2.25588
Reported LPN Staffing Hours per Resident per Day
0.60588
Reported RN Staffing Hours per Resident per Day
1.12353
Reported Licensed Staffing Hours per Resident per Day
1.72941
Reported Total Nurse Staffing Hours per Resident per Day
3.98529
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05588
Expected CNA Staffing Hours per Resident per Day
2.41379
Expected LPN Staffing Hours per Resident per Day
0.62410
Expected RN Staffing Hours per Resident per Day
0.92177
Expected Total Nurse Staffing Hours per Resident per Day
3.95966
Adjusted CNA Staffing Hours per Resident per Day
2.29318
Adjusted LPN Staffing Hours per Resident per Day
0.80577
Adjusted RN Staffing Hours per Resident per Day
0.91075
Adjusted Total Nurse Staffing Hours per Resident per Day
4.05699
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
2015-02-25
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
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-01-29
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-10-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
10.66700
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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