St Ann Rest Home - Milwaukee Nursing Home
General Information
UPDATEFederal Provider Number
52A431
Provider Name
ST ANN REST HOME
Provider Address
2020 S MUSKEGO AVE
MILWAUKEE, WI 53204
MILWAUKEE, WI 53204
Provider Phone Number
(414) 383-2630
Provider SSA County
390
Provider County Name
Milwaukee
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
47
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1991-11-01
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
2.40213
Reported LPN Staffing Hours per Resident per Day
0.37766
Reported RN Staffing Hours per Resident per Day
0.95319
Reported Licensed Staffing Hours per Resident per Day
1.33085
Reported Total Nurse Staffing Hours per Resident per Day
3.73298
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03085
Expected CNA Staffing Hours per Resident per Day
2.61335
Expected LPN Staffing Hours per Resident per Day
0.55995
Expected RN Staffing Hours per Resident per Day
0.75577
Expected Total Nurse Staffing Hours per Resident per Day
3.92907
Adjusted CNA Staffing Hours per Resident per Day
2.25538
Adjusted LPN Staffing Hours per Resident per Day
0.55980
Adjusted RN Staffing Hours per Resident per Day
0.94238
Adjusted Total Nurse Staffing Hours per Resident per Day
3.82973
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-11-26
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
2013-11-14
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
8
Cycle 3 Standard Health Survey Date
2012-11-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
1.33300
Number of Facility Reported Incidents
0
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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