Wheaton Franciscan Hc - Lakeshore Manor - Racine Nursing Home
General Information
UPDATEFederal Provider Number
525495
Provider Name
WHEATON FRANCISCAN HC - LAKESHORE MANOR
Provider Address
1320 WISCONSIN AVE
RACINE, WI 53403
RACINE, WI 53403
Provider Phone Number
(262) 687-2241
Provider SSA County
500
Provider County Name
Racine
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
50
Number of Residents in Certified Beds
49
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WHEATON FRANCISCAN HEALTHCARE-ALL SAINTS, INC.
Date First Approved to Provide Medicare and Medicaid services
1992-08-18
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
3
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
2.97143
Reported LPN Staffing Hours per Resident per Day
0.28265
Reported RN Staffing Hours per Resident per Day
1.49286
Reported Licensed Staffing Hours per Resident per Day
1.77551
Reported Total Nurse Staffing Hours per Resident per Day
4.74694
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11939
Expected CNA Staffing Hours per Resident per Day
2.54540
Expected LPN Staffing Hours per Resident per Day
0.65106
Expected RN Staffing Hours per Resident per Day
1.19732
Expected Total Nurse Staffing Hours per Resident per Day
4.39378
Adjusted CNA Staffing Hours per Resident per Day
2.86439
Adjusted LPN Staffing Hours per Resident per Day
0.36033
Adjusted RN Staffing Hours per Resident per Day
0.93163
Adjusted Total Nurse Staffing Hours per Resident per Day
4.35489
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-04-28
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-06-27
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-04-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
4.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
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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