St Francis Home - Fond Du Lac Nursing Home
General Information
UPDATEFederal Provider Number
525595
Provider Name
ST FRANCIS HOME
Provider Address
33 EVERETT ST
FOND DU LAC, WI 54935
FOND DU LAC, WI 54935
Provider Phone Number
(920) 923-7980
Provider SSA County
190
Provider County Name
Fond Du Lac
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
107
Number of Residents in Certified Beds
98
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST. FRANCIS HOME
Date First Approved to Provide Medicare and Medicaid services
1996-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
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
3.18163
Reported LPN Staffing Hours per Resident per Day
0.30918
Reported RN Staffing Hours per Resident per Day
0.92194
Reported Licensed Staffing Hours per Resident per Day
1.23112
Reported Total Nurse Staffing Hours per Resident per Day
4.41275
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05612
Expected CNA Staffing Hours per Resident per Day
2.61309
Expected LPN Staffing Hours per Resident per Day
0.58675
Expected RN Staffing Hours per Resident per Day
0.85434
Expected Total Nurse Staffing Hours per Resident per Day
4.05418
Adjusted CNA Staffing Hours per Resident per Day
2.98756
Adjusted LPN Staffing Hours per Resident per Day
0.43736
Adjusted RN Staffing Hours per Resident per Day
0.80632
Adjusted Total Nurse Staffing Hours per Resident per Day
4.38741
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
2014-04-29
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
8
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-02-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-02-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
24.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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