Willow Ridge Healthcare - Amery Nursing Home
General Information
UPDATEFederal Provider Number
525402
Provider Name
WILLOW RIDGE HEALTHCARE
Provider Address
400 DERONDA ST
AMERY, WI 54001
AMERY, WI 54001
Provider Phone Number
(715) 268-8171
Provider SSA County
470
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
83
Number of Residents in Certified Beds
45
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WILLOW RIDGE HEALTHCARE FACILITIES, LLC
Date First Approved to Provide Medicare and Medicaid services
1986-07-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.61667
Reported LPN Staffing Hours per Resident per Day
0.96000
Reported RN Staffing Hours per Resident per Day
0.42111
Reported Licensed Staffing Hours per Resident per Day
1.38111
Reported Total Nurse Staffing Hours per Resident per Day
3.99778
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06333
Expected CNA Staffing Hours per Resident per Day
2.34672
Expected LPN Staffing Hours per Resident per Day
0.70922
Expected RN Staffing Hours per Resident per Day
1.08119
Expected Total Nurse Staffing Hours per Resident per Day
4.13713
Adjusted CNA Staffing Hours per Resident per Day
2.73596
Adjusted LPN Staffing Hours per Resident per Day
1.12348
Adjusted RN Staffing Hours per Resident per Day
0.29103
Adjusted Total Nurse Staffing Hours per Resident per Day
3.89513
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2015-04-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2014-05-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
92
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2013-03-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
60.00000
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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