St Elizabeth Nursing Home - Janesville Nursing Home
General Information
UPDATEFederal Provider Number
525639
Provider Name
ST ELIZABETH NURSING HOME
Provider Address
109 S ATWOOD AVENUE
JANESVILLE, WI 53545
JANESVILLE, WI 53545
Provider Phone Number
(608) 752-6709
Provider SSA County
520
Provider County Name
Rock
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
43
Number of Residents in Certified Beds
42
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SISTERS OF CHARITY OF OUR LADY MOTHER OF THE CHURCH
Date First Approved to Provide Medicare and Medicaid services
1998-02-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
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
3.32738
Reported LPN Staffing Hours per Resident per Day
0.82024
Reported RN Staffing Hours per Resident per Day
0.82619
Reported Licensed Staffing Hours per Resident per Day
1.64643
Reported Total Nurse Staffing Hours per Resident per Day
4.97381
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01667
Expected CNA Staffing Hours per Resident per Day
2.55096
Expected LPN Staffing Hours per Resident per Day
0.60477
Expected RN Staffing Hours per Resident per Day
0.95537
Expected Total Nurse Staffing Hours per Resident per Day
4.11109
Adjusted CNA Staffing Hours per Resident per Day
3.20052
Adjusted LPN Staffing Hours per Resident per Day
1.12572
Adjusted RN Staffing Hours per Resident per Day
0.64617
Adjusted Total Nurse Staffing Hours per Resident per Day
4.87679
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
450
Cycle 1 Standard Survey Health Date
2015-04-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
450
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2014-03-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2013-02-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
251.66700
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
3
Number of Fines
4
Total Amount of Fines in Dollars
27690
Number of Payment Denials
0
Total Number of Penalties
4
Location
Processing Date
2015-06-01
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