St Camillus Health Center - Wauwatosa Nursing Home
General Information
UPDATEFederal Provider Number
525382
Provider Name
ST CAMILLUS HEALTH CENTER
Provider Address
10101 W WISCONSIN AVE
WAUWATOSA, WI 53226
WAUWATOSA, WI 53226
Provider Phone Number
(414) 258-1814
Provider SSA County
390
Provider County Name
Milwaukee
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
67
Number of Residents in Certified Beds
54
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST. CAMILLUS HEALTH CENTER, INC.
Date First Approved to Provide Medicare and Medicaid services
1985-04-01
Continuing Care Retirement Community
Y
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
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.79630
Reported LPN Staffing Hours per Resident per Day
0.76019
Reported RN Staffing Hours per Resident per Day
0.80926
Reported Licensed Staffing Hours per Resident per Day
1.56944
Reported Total Nurse Staffing Hours per Resident per Day
4.36575
Reported Physical Therapist Staffing Hours per Resident Per Day
0.27500
Expected CNA Staffing Hours per Resident per Day
2.44043
Expected LPN Staffing Hours per Resident per Day
0.56514
Expected RN Staffing Hours per Resident per Day
0.93683
Expected Total Nurse Staffing Hours per Resident per Day
3.94241
Adjusted CNA Staffing Hours per Resident per Day
2.81150
Adjusted LPN Staffing Hours per Resident per Day
1.11645
Adjusted RN Staffing Hours per Resident per Day
0.64545
Adjusted Total Nurse Staffing Hours per Resident per Day
4.46374
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
111
Cycle 1 Standard Survey Health Date
2014-06-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
111
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-05-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-03-22
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
62.16700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
10000
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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