Wisconsin Nursing Homes >> Lake Mills Nursing Homes >> Willowbrook Nursing And Rehab

Willowbrook Nursing And Rehab - Lake Mills Nursing Home

General Information

UPDATE
Federal Provider Number
525314
Provider Name
WILLOWBROOK NURSING AND REHAB
Provider Address
901 MULBERRY ST
LAKE MILLS, WI 53551
Provider Phone Number
9206488344
Provider SSA County
270
Provider County Name
Jefferson
Ownership Type
For profit - Corporation
Number of Certified Beds
57
Number of Residents in Certified Beds
47
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EXTENDICARE HEALTH FACILITIES INC.
Date First Approved to Provide Medicare and Medicaid services
1981-07-14
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
5
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
2.40000
Reported LPN Staffing Hours per Resident per Day
0.37234
Reported RN Staffing Hours per Resident per Day
1.42340
Reported Licensed Staffing Hours per Resident per Day
1.79574
Reported Total Nurse Staffing Hours per Resident per Day
4.19574
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08617
Expected CNA Staffing Hours per Resident per Day
2.56661
Expected LPN Staffing Hours per Resident per Day
0.72198
Expected RN Staffing Hours per Resident per Day
1.22942
Expected Total Nurse Staffing Hours per Resident per Day
4.51801
Adjusted CNA Staffing Hours per Resident per Day
2.29442
Adjusted LPN Staffing Hours per Resident per Day
0.42805
Adjusted RN Staffing Hours per Resident per Day
0.86510
Adjusted Total Nurse Staffing Hours per Resident per Day
3.74338
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-08-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-11-14
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
10
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
10
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-09-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
20.66700
Number of Facility Reported Incidents
3
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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