Wi Veterans Home At Chippewa Falls - Chippewa Falls Nursing Home
General Information
UPDATEFederal Provider Number
525708
Provider Name
WI VETERANS HOME AT CHIPPEWA FALLS
Provider Address
2175 E PARK AVE
CHIPPEWA FALLS, WI 54729
CHIPPEWA FALLS, WI 54729
Provider Phone Number
(715) 720-6775
Provider SSA County
80
Provider County Name
Chippewa
Provider Website
Provider Description
Ownership Type
Government - State
Number of Certified Beds
72
Number of Residents in Certified Beds
71
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
STATE OF WISCONSIN
Date First Approved to Provide Medicare and Medicaid services
2013-02-13
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
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
5
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
2.75986
Reported LPN Staffing Hours per Resident per Day
0.97465
Reported RN Staffing Hours per Resident per Day
0.96197
Reported Licensed Staffing Hours per Resident per Day
1.93662
Reported Total Nurse Staffing Hours per Resident per Day
4.69648
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01620
Expected CNA Staffing Hours per Resident per Day
2.19324
Expected LPN Staffing Hours per Resident per Day
0.63867
Expected RN Staffing Hours per Resident per Day
0.94590
Expected Total Nurse Staffing Hours per Resident per Day
3.77781
Adjusted CNA Staffing Hours per Resident per Day
3.08761
Adjusted LPN Staffing Hours per Resident per Day
1.26663
Adjusted RN Staffing Hours per Resident per Day
0.75990
Adjusted Total Nurse Staffing Hours per Resident per Day
5.01111
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-02-02
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
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2014-03-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
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
2013-02-11
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
29.33300
Number of Facility Reported Incidents
1
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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