Santa Maria Nursing Home - Green Bay Nursing Home
General Information
UPDATEFederal Provider Number
525590
Provider Name
SANTA MARIA NURSING HOME
Provider Address
430 S CLAY ST
GREEN BAY, WI 54301
GREEN BAY, WI 54301
Provider Phone Number
(920) 432-5231
Provider SSA County
40
Provider County Name
Brown
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
45
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SANTA MARIA NURSING HOME, INC.
Date First Approved to Provide Medicare and Medicaid services
1996-04-15
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
4
Overall Rating Footnote
Health Inspection Rating
3
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
3.29333
Reported LPN Staffing Hours per Resident per Day
0.56444
Reported RN Staffing Hours per Resident per Day
0.83667
Reported Licensed Staffing Hours per Resident per Day
1.40111
Reported Total Nurse Staffing Hours per Resident per Day
4.69444
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03222
Expected CNA Staffing Hours per Resident per Day
2.52229
Expected LPN Staffing Hours per Resident per Day
0.60998
Expected RN Staffing Hours per Resident per Day
0.87609
Expected Total Nurse Staffing Hours per Resident per Day
4.00837
Adjusted CNA Staffing Hours per Resident per Day
3.20377
Adjusted LPN Staffing Hours per Resident per Day
0.76803
Adjusted RN Staffing Hours per Resident per Day
0.71358
Adjusted Total Nurse Staffing Hours per Resident per Day
4.72083
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-10-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2014-01-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-10-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
41.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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