St Clare Meadows Care Ctr - Baraboo Nursing Home
General Information
UPDATEFederal Provider Number
525317
Provider Name
ST CLARE MEADOWS CARE CTR
Provider Address
1414 JEFFERSON ST
BARABOO, WI 53913
BARABOO, WI 53913
Provider Phone Number
(608) 356-4838
Provider SSA County
550
Provider County Name
Sauk
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
102
Number of Residents in Certified Beds
97
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SSM HEALTHCARE OF WISCONSIN INC
Date First Approved to Provide Medicare and Medicaid services
1982-02-01
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
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.59278
Reported LPN Staffing Hours per Resident per Day
0.54691
Reported RN Staffing Hours per Resident per Day
0.82113
Reported Licensed Staffing Hours per Resident per Day
1.36804
Reported Total Nurse Staffing Hours per Resident per Day
3.96082
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11134
Expected CNA Staffing Hours per Resident per Day
2.52573
Expected LPN Staffing Hours per Resident per Day
0.66344
Expected RN Staffing Hours per Resident per Day
1.21951
Expected Total Nurse Staffing Hours per Resident per Day
4.40868
Adjusted CNA Staffing Hours per Resident per Day
2.51884
Adjusted LPN Staffing Hours per Resident per Day
0.68422
Adjusted RN Staffing Hours per Resident per Day
0.50311
Adjusted Total Nurse Staffing Hours per Resident per Day
3.62142
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2015-02-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2014-04-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2013-01-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
58.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
878
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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