Trempealeau Cty Hcc Imd - Whitehall Nursing Home
General Information
UPDATEFederal Provider Number
52A407
Provider Name
TREMPEALEAU CTY HCC IMD
Provider Address
W20298 STATE RD 121
WHITEHALL, WI 54773
WHITEHALL, WI 54773
Provider Phone Number
(715) 538-4312
Provider SSA County
600
Provider County Name
Trempealeau
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
34
Number of Residents in Certified Beds
34
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1988-11-30
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
4
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
1
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
2.35294
Reported LPN Staffing Hours per Resident per Day
0.20147
Reported RN Staffing Hours per Resident per Day
1.18529
Reported Licensed Staffing Hours per Resident per Day
1.38676
Reported Total Nurse Staffing Hours per Resident per Day
3.73970
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00588
Expected CNA Staffing Hours per Resident per Day
2.78791
Expected LPN Staffing Hours per Resident per Day
0.58709
Expected RN Staffing Hours per Resident per Day
0.72540
Expected Total Nurse Staffing Hours per Resident per Day
4.10040
Adjusted CNA Staffing Hours per Resident per Day
2.07087
Adjusted LPN Staffing Hours per Resident per Day
0.28483
Adjusted RN Staffing Hours per Resident per Day
1.22091
Adjusted Total Nurse Staffing Hours per Resident per Day
3.67631
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-03-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-03-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2013-02-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
5.33300
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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