Roubal Care And Rehab Center - Stephenson Nursing Home
General Information
UPDATEFederal Provider Number
235591
Provider Name
ROUBAL CARE AND REHAB CENTER
Provider Address
N 306 MAPLE STREET
STEPHENSON, MI 49887
STEPHENSON, MI 49887
Provider Phone Number
(906) 753-4981
Provider SSA County
540
Provider County Name
Menominee
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
39
Number of Residents in Certified Beds
38
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ROUBALS NURSING HOME INC
Date First Approved to Provide Medicare and Medicaid services
1999-08-01
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
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
2.36842
Reported LPN Staffing Hours per Resident per Day
0.68421
Reported RN Staffing Hours per Resident per Day
0.71316
Reported Licensed Staffing Hours per Resident per Day
1.39737
Reported Total Nurse Staffing Hours per Resident per Day
3.76579
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00526
Expected CNA Staffing Hours per Resident per Day
2.60769
Expected LPN Staffing Hours per Resident per Day
0.55073
Expected RN Staffing Hours per Resident per Day
0.72287
Expected Total Nurse Staffing Hours per Resident per Day
3.88128
Adjusted CNA Staffing Hours per Resident per Day
2.22856
Adjusted LPN Staffing Hours per Resident per Day
1.03117
Adjusted RN Staffing Hours per Resident per Day
0.73717
Adjusted Total Nurse Staffing Hours per Resident per Day
3.91095
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-04-17
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
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-03-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-02-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
20.66700
Number of Facility Reported Incidents
4
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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