Sunny Ridge Health And Rehab Center - Sheboygan Nursing Home
General Information
UPDATEFederal Provider Number
525568
Provider Name
SUNNY RIDGE HEALTH AND REHAB CENTER
Provider Address
3014 ERIE AVE
SHEBOYGAN, WI 53081
SHEBOYGAN, WI 53081
Provider Phone Number
(920) 459-3028
Provider SSA County
580
Provider County Name
Sheboygan
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
121
Number of Residents in Certified Beds
102
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LSS OF SHEBOYGAN, LLC
Date First Approved to Provide Medicare and Medicaid services
1995-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
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
1.71078
Reported LPN Staffing Hours per Resident per Day
0.29608
Reported RN Staffing Hours per Resident per Day
0.74804
Reported Licensed Staffing Hours per Resident per Day
1.04412
Reported Total Nurse Staffing Hours per Resident per Day
2.75490
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09657
Expected CNA Staffing Hours per Resident per Day
2.31516
Expected LPN Staffing Hours per Resident per Day
0.61557
Expected RN Staffing Hours per Resident per Day
0.99088
Expected Total Nurse Staffing Hours per Resident per Day
3.92161
Adjusted CNA Staffing Hours per Resident per Day
1.81315
Adjusted LPN Staffing Hours per Resident per Day
0.39922
Adjusted RN Staffing Hours per Resident per Day
0.56408
Adjusted Total Nurse Staffing Hours per Resident per Day
2.83167
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
164
Cycle 1 Standard Survey Health Date
2014-07-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
164
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-05-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
64
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
225
Cycle 3 Standard Health Survey Date
2012-06-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
225
Total Weighted Health Survey Score
140.83300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
13910
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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