St Joseph's Home And Rehabilitation Center - Kenosha Nursing Home
General Information
UPDATEFederal Provider Number
525603
Provider Name
ST JOSEPH'S HOME AND REHABILITATION CENTER
Provider Address
9244 29TH AVE
KENOSHA, WI 53143
KENOSHA, WI 53143
Provider Phone Number
(262) 694-0080
Provider SSA County
290
Provider County Name
Kenosha
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
73
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST. JOSEPH'S HOME OF OUR LADY OF MT CARMEL INC
Date First Approved to Provide Medicare and Medicaid services
1996-11-01
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
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
2.68014
Reported LPN Staffing Hours per Resident per Day
0.45548
Reported RN Staffing Hours per Resident per Day
0.94247
Reported Licensed Staffing Hours per Resident per Day
1.39795
Reported Total Nurse Staffing Hours per Resident per Day
4.07809
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07260
Expected CNA Staffing Hours per Resident per Day
2.56464
Expected LPN Staffing Hours per Resident per Day
0.64332
Expected RN Staffing Hours per Resident per Day
0.99363
Expected Total Nurse Staffing Hours per Resident per Day
4.20159
Adjusted CNA Staffing Hours per Resident per Day
2.56420
Adjusted LPN Staffing Hours per Resident per Day
0.58765
Adjusted RN Staffing Hours per Resident per Day
0.70873
Adjusted Total Nurse Staffing Hours per Resident per Day
3.91242
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
2014-07-24
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
2013-08-19
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
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
2012-05-24
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
0.00000
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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