Rocky Knoll Health Care - Plymouth Nursing Home
General Information
UPDATEFederal Provider Number
525337
Provider Name
ROCKY KNOLL HEALTH CARE
Provider Address
N7135 ROCKY KNOLL PARKWAY
PLYMOUTH, WI 53073
PLYMOUTH, WI 53073
Provider Phone Number
(920) 893-6441
Provider SSA County
580
Provider County Name
Sheboygan
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
155
Number of Residents in Certified Beds
126
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTY OF SHEBOYGAN
Date First Approved to Provide Medicare and Medicaid services
1983-08-18
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.86667
Reported LPN Staffing Hours per Resident per Day
0.84921
Reported RN Staffing Hours per Resident per Day
0.69008
Reported Licensed Staffing Hours per Resident per Day
1.53929
Reported Total Nurse Staffing Hours per Resident per Day
4.40596
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06984
Expected CNA Staffing Hours per Resident per Day
2.40741
Expected LPN Staffing Hours per Resident per Day
0.64211
Expected RN Staffing Hours per Resident per Day
0.97125
Expected Total Nurse Staffing Hours per Resident per Day
4.02076
Adjusted CNA Staffing Hours per Resident per Day
2.92179
Adjusted LPN Staffing Hours per Resident per Day
1.09771
Adjusted RN Staffing Hours per Resident per Day
0.53089
Adjusted Total Nurse Staffing Hours per Resident per Day
4.41707
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-04-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2014-04-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
112
Cycle 3 Standard Health Survey Date
2013-02-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
112
Total Weighted Health Survey Score
44.00000
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
10238
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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