Rock Haven - Janesville Nursing Home
General Information
UPDATEFederal Provider Number
525390
Provider Name
ROCK HAVEN
Provider Address
3400 N CTY TRK HWY F PO BOX 920
JANESVILLE, WI 53547
JANESVILLE, WI 53547
Provider Phone Number
(608) 757-5076
Provider SSA County
520
Provider County Name
Rock
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
128
Number of Residents in Certified Beds
120
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTY OF ROCK COUNTY CLERK
Date First Approved to Provide Medicare and Medicaid services
1985-07-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
5
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
3.40833
Reported LPN Staffing Hours per Resident per Day
0.51125
Reported RN Staffing Hours per Resident per Day
1.31375
Reported Licensed Staffing Hours per Resident per Day
1.82500
Reported Total Nurse Staffing Hours per Resident per Day
5.23333
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01667
Expected CNA Staffing Hours per Resident per Day
2.60273
Expected LPN Staffing Hours per Resident per Day
0.67579
Expected RN Staffing Hours per Resident per Day
0.95899
Expected Total Nurse Staffing Hours per Resident per Day
4.23750
Adjusted CNA Staffing Hours per Resident per Day
3.21317
Adjusted LPN Staffing Hours per Resident per Day
0.62792
Adjusted RN Staffing Hours per Resident per Day
1.02362
Adjusted Total Nurse Staffing Hours per Resident per Day
4.97818
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
244
Cycle 1 Standard Survey Health Date
2014-09-03
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
122
Cycle 1 Total Health Score
366
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2013-06-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
92
Cycle 3 Total Number of Health Deficiencies
17
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
116
Cycle 3 Standard Health Survey Date
2012-03-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
116
Total Weighted Health Survey Score
233.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
8
Number of Fines
2
Total Amount of Fines in Dollars
93991
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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