Sarah Chudnow Campus - Mequon Nursing Home
General Information
UPDATEFederal Provider Number
525682
Provider Name
SARAH CHUDNOW CAMPUS
Provider Address
10995 N MARKET ST
MEQUON, WI 53092
MEQUON, WI 53092
Provider Phone Number
(262) 478-1501
Provider SSA County
440
Provider County Name
Ozaukee
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
25
Number of Residents in Certified Beds
22
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
MEQUON JEWISH CAMPUS, INC
Date First Approved to Provide Medicare and Medicaid services
2005-05-18
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
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
3.01364
Reported LPN Staffing Hours per Resident per Day
0.51818
Reported RN Staffing Hours per Resident per Day
1.58636
Reported Licensed Staffing Hours per Resident per Day
2.10455
Reported Total Nurse Staffing Hours per Resident per Day
5.11818
Reported Physical Therapist Staffing Hours per Resident Per Day
0.25909
Expected CNA Staffing Hours per Resident per Day
2.55270
Expected LPN Staffing Hours per Resident per Day
0.78035
Expected RN Staffing Hours per Resident per Day
1.54163
Expected Total Nurse Staffing Hours per Resident per Day
4.87468
Adjusted CNA Staffing Hours per Resident per Day
2.89676
Adjusted LPN Staffing Hours per Resident per Day
0.55115
Adjusted RN Staffing Hours per Resident per Day
0.76888
Adjusted Total Nurse Staffing Hours per Resident per Day
4.23225
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-04-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-01-31
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-02-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
12.66700
Number of Facility Reported Incidents
2
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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