The Willows Nursing And Rehab - Sun Prairie Nursing Home
General Information
UPDATEFederal Provider Number
525313
Provider Name
THE WILLOWS NURSING AND REHAB
Provider Address
41 RICKEL RD
SUN PRAIRIE, WI 53590
SUN PRAIRIE, WI 53590
Provider Phone Number
(608) 837-8529
Provider SSA County
120
Provider County Name
Dane
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
57
Number of Residents in Certified Beds
51
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EXTENDICARE HEALTH FACILITIES INC.
Date First Approved to Provide Medicare and Medicaid services
1981-07-23
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
4
QM Rating Footnote
Staffing Rating
3
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
1.85392
Reported LPN Staffing Hours per Resident per Day
0.32255
Reported RN Staffing Hours per Resident per Day
1.19118
Reported Licensed Staffing Hours per Resident per Day
1.51373
Reported Total Nurse Staffing Hours per Resident per Day
3.36765
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13039
Expected CNA Staffing Hours per Resident per Day
2.60113
Expected LPN Staffing Hours per Resident per Day
0.68250
Expected RN Staffing Hours per Resident per Day
1.11705
Expected Total Nurse Staffing Hours per Resident per Day
4.40068
Adjusted CNA Staffing Hours per Resident per Day
1.74884
Adjusted LPN Staffing Hours per Resident per Day
0.39226
Adjusted RN Staffing Hours per Resident per Day
0.79678
Adjusted Total Nurse Staffing Hours per Resident per Day
3.08467
Cycle 1 Total Number of Health Deficiencies
18
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
9
Cycle 1 Health Deficiency Score
176
Cycle 1 Standard Survey Health Date
2014-04-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
176
Cycle 2 Total Number of Health Deficiencies
26
Cycle 2 Number of Standard Health Deficiencies
21
Cycle 2 Number of Complaint Health Deficiencies
14
Cycle 2 Health Deficiency Score
297
Cycle 2 Standard Health Survey Date
2013-03-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
297
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
7
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2012-01-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
201.66700
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
18
Number of Fines
4
Total Amount of Fines in Dollars
69795
Number of Payment Denials
2
Total Number of Penalties
6
Location
Processing Date
2015-06-01
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