Wi Veterans Hm Ainsworth 800 - King Nursing Home
General Information
UPDATEFederal Provider Number
525719
Provider Name
WI VETERANS HM AINSWORTH 800
Provider Address
N2665 CTY RD QQ
KING, WI 54946
KING, WI 54946
Provider Phone Number
(715) 258-5586
Provider SSA County
670
Provider County Name
Waupaca
Provider Website
Provider Description
Ownership Type
Government - State
Number of Certified Beds
205
Number of Residents in Certified Beds
197
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
2015-03-01
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
0
Overall Rating Footnote
Too New to Rate
Health Inspection Rating
0
Health Inspection Rating Footnote
Too New to Rate
QM Rating
0
QM Rating Footnote
Too New to Rate
Staffing Rating
0
Staffing Rating Footnote
Too New to Rate
RN Staffing Rating
0
RN Staffing Rating Footnote
Too New to Rate
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.63452
Reported LPN Staffing Hours per Resident per Day
0.50127
Reported RN Staffing Hours per Resident per Day
0.71218
Reported Licensed Staffing Hours per Resident per Day
1.21345
Reported Total Nurse Staffing Hours per Resident per Day
3.84797
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01624
Expected CNA Staffing Hours per Resident per Day
0.00000
Expected LPN Staffing Hours per Resident per Day
0.00000
Expected RN Staffing Hours per Resident per Day
0.00000
Expected Total Nurse Staffing Hours per Resident per Day
0.00000
Adjusted CNA Staffing Hours per Resident per Day
0.00000
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.00000
Adjusted Total Nurse Staffing Hours per Resident per Day
0.00000
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
0000-00-00
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
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
0000-00-00
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
0.00000
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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