United Pioneer Home - Luck Nursing Home
General Information
UPDATEFederal Provider Number
525680
Provider Name
UNITED PIONEER HOME
Provider Address
623 S SECOND ST
LUCK, WI 54853
LUCK, WI 54853
Provider Phone Number
(715) 472-2164
Provider SSA County
470
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
48
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2004-11-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.69688
Reported LPN Staffing Hours per Resident per Day
0.51354
Reported RN Staffing Hours per Resident per Day
0.64479
Reported Licensed Staffing Hours per Resident per Day
1.15833
Reported Total Nurse Staffing Hours per Resident per Day
3.85521
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00938
Expected CNA Staffing Hours per Resident per Day
2.53665
Expected LPN Staffing Hours per Resident per Day
0.60798
Expected RN Staffing Hours per Resident per Day
0.99999
Expected Total Nurse Staffing Hours per Resident per Day
4.14462
Adjusted CNA Staffing Hours per Resident per Day
2.60869
Adjusted LPN Staffing Hours per Resident per Day
0.70107
Adjusted RN Staffing Hours per Resident per Day
0.48179
Adjusted Total Nurse Staffing Hours per Resident per Day
3.74943
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-01-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2014-03-20
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
36
Cycle 2 Total Health Score
108
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
465
Cycle 3 Standard Health Survey Date
2013-02-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
465
Total Weighted Health Survey Score
129.50000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
0
Number of Fines
2
Total Amount of Fines in Dollars
55770
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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