Shady Lane Nursing Care Center - Manitowoc Nursing Home
General Information
UPDATEFederal Provider Number
525575
Provider Name
SHADY LANE NURSING CARE CENTER
Provider Address
1235 S 24TH ST
MANITOWOC, WI 54220
MANITOWOC, WI 54220
Provider Phone Number
9206828254
Provider SSA County
350
Provider County Name
Manitowoc
Ownership Type
Non profit - Corporation
Number of Certified Beds
116
Number of Residents in Certified Beds
96
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SHADY LANE HOME, INC.
Date First Approved to Provide Medicare and Medicaid services
1995-10-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
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
3.07500
Reported LPN Staffing Hours per Resident per Day
0.46979
Reported RN Staffing Hours per Resident per Day
1.03177
Reported Licensed Staffing Hours per Resident per Day
1.50156
Reported Total Nurse Staffing Hours per Resident per Day
4.57656
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03802
Expected CNA Staffing Hours per Resident per Day
2.58936
Expected LPN Staffing Hours per Resident per Day
0.64147
Expected RN Staffing Hours per Resident per Day
0.94600
Expected Total Nurse Staffing Hours per Resident per Day
4.17683
Adjusted CNA Staffing Hours per Resident per Day
2.91390
Adjusted LPN Staffing Hours per Resident per Day
0.60786
Adjusted RN Staffing Hours per Resident per Day
0.81495
Adjusted Total Nurse Staffing Hours per Resident per Day
4.41666
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
87
Cycle 1 Standard Survey Health Date
2014-09-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
87
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-08-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
12
Cycle 3 Standard Health Survey Date
2012-07-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
60.16700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
3900
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
St Marys Home For The Aged
1635 S 21st Street |
MANITOWOC WI 54220 | 0.5 mile away
Rivers Bend Hlth Rehab
960 S Rapids Rd |
MANITOWOC WI 54220 | 1.5 miles away
North Ridge Medical And Rehabilitation Center
1445 N 7th St |
MANITOWOC WI 54220 | 2.4 miles away
Manitowoc Health Care Center
2021 S Alverno Rd |
MANITOWOC WI 54220 | 3.2 miles away
Atrium Post Acute Care Of Two Rivers
1 Hamilton Dr |
TWO RIVERS WI 54241 | 7.8 miles away
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