Rice Lake Conv Ctr - Rice Lake Nursing Home
General Information
UPDATEFederal Provider Number
525654
Provider Name
RICE LAKE CONV CTR
Provider Address
1016 LAKESHORE DR
RICE LAKE, WI 54868
RICE LAKE, WI 54868
Provider Phone Number
(715) 234-9101
Provider SSA County
20
Provider County Name
Barron
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
85
Number of Residents in Certified Beds
58
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FIRST AMERICAN ENTERPRISES INC
Date First Approved to Provide Medicare and Medicaid services
2000-03-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
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
2.06638
Reported LPN Staffing Hours per Resident per Day
0.55086
Reported RN Staffing Hours per Resident per Day
0.90172
Reported Licensed Staffing Hours per Resident per Day
1.45259
Reported Total Nurse Staffing Hours per Resident per Day
3.51896
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07759
Expected CNA Staffing Hours per Resident per Day
2.42864
Expected LPN Staffing Hours per Resident per Day
0.67772
Expected RN Staffing Hours per Resident per Day
1.14038
Expected Total Nurse Staffing Hours per Resident per Day
4.24675
Adjusted CNA Staffing Hours per Resident per Day
2.08770
Adjusted LPN Staffing Hours per Resident per Day
0.67464
Adjusted RN Staffing Hours per Resident per Day
0.59082
Adjusted Total Nurse Staffing Hours per Resident per Day
3.34010
Cycle 1 Total Number of Health Deficiencies
18
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
12
Cycle 1 Health Deficiency Score
221
Cycle 1 Standard Survey Health Date
2014-11-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
221
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-08-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
64
Cycle 3 Total Number of Health Deficiencies
17
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
7
Cycle 3 Health Deficiency Score
243
Cycle 3 Standard Health Survey Date
2012-07-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
243
Total Weighted Health Survey Score
172.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
9
Number of Fines
1
Total Amount of Fines in Dollars
6500
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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