Wisconsin Nursing Homes >> Wild Rose Nursing Homes >> Wild Rose Manor

Wild Rose Manor - Wild Rose Nursing Home

General Information

UPDATE
Federal Provider Number
525496
Provider Name
WILD ROSE MANOR
Provider Address
425 SUMMIT ST
WILD ROSE, WI 54984
Provider Phone Number
9206224342
Provider SSA County
680
Provider County Name
Waushara
Ownership Type
Non profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
37
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WISCONSIN ILLINOIS SENIOR HOUSING INC
Date First Approved to Provide Medicare and Medicaid services
1992-11-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
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
2.91757
Reported LPN Staffing Hours per Resident per Day
0.81351
Reported RN Staffing Hours per Resident per Day
1.05811
Reported Licensed Staffing Hours per Resident per Day
1.87162
Reported Total Nurse Staffing Hours per Resident per Day
4.78919
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02297
Expected CNA Staffing Hours per Resident per Day
2.37904
Expected LPN Staffing Hours per Resident per Day
0.58306
Expected RN Staffing Hours per Resident per Day
0.96653
Expected Total Nurse Staffing Hours per Resident per Day
3.92863
Adjusted CNA Staffing Hours per Resident per Day
3.00913
Adjusted LPN Staffing Hours per Resident per Day
1.15805
Adjusted RN Staffing Hours per Resident per Day
0.81800
Adjusted Total Nurse Staffing Hours per Resident per Day
4.91386
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-09-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-07-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-06-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
43.33300
Number of Facility Reported Incidents
2
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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