Virginia Health And Rehab Ctr - Waukesha Nursing Home
General Information
UPDATEFederal Provider Number
525490
Provider Name
VIRGINIA HEALTH AND REHAB CTR
Provider Address
1451 CLEVELAND AVE
WAUKESHA, WI 53186
WAUKESHA, WI 53186
Provider Phone Number
(262) 547-2123
Provider SSA County
660
Provider County Name
Waukesha
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
105
Number of Residents in Certified Beds
95
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FIVE STAR QUALITY CARE-WI, LLC
Date First Approved to Provide Medicare and Medicaid services
1992-06-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.12000
Reported LPN Staffing Hours per Resident per Day
0.49632
Reported RN Staffing Hours per Resident per Day
0.64842
Reported Licensed Staffing Hours per Resident per Day
1.14474
Reported Total Nurse Staffing Hours per Resident per Day
3.26474
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04684
Expected CNA Staffing Hours per Resident per Day
2.40266
Expected LPN Staffing Hours per Resident per Day
0.54832
Expected RN Staffing Hours per Resident per Day
0.76947
Expected Total Nurse Staffing Hours per Resident per Day
3.72045
Adjusted CNA Staffing Hours per Resident per Day
2.16503
Adjusted LPN Staffing Hours per Resident per Day
0.75128
Adjusted RN Staffing Hours per Resident per Day
0.62966
Adjusted Total Nurse Staffing Hours per Resident per Day
3.53716
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2015-04-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2014-01-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-11-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
42.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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