| General |
| City |
| Rib Lake |
Spring Valley |
| State attribute explanation |
| Wi |
Wi |
| Street |
| 650 Pearl St Po Box 308 |
S830 - Westland Dr |
| Zip Code |
| 54,470 |
54,767 |
| Phone |
| 7,154,275,291 |
7,157,785,545 |
|
Overall Star Rating |
| 3 |
5 |
|
Health Inspections Star Rating |
| 2 |
4 |
|
Nurse Staffing Star Rating |
| 4 |
5 |
|
Quality Measures Star Rating |
| 4 |
4 |
|
RN Only Star Rating |
| 5 |
5 |
|
Number of Certified Beds |
| 60 |
50 |
|
Total Number of Residents |
| 37 |
39 |
|
Percent of Occupied Beds |
| 62 % |
78 % |
| Health Survey Date |
| 6/14/2012 |
5/5/2011 |
| Fire Survey Date |
| 6/22/2012 |
5/5/2011 |
| Sprinkler Status |
| Fully Sprinklered |
Partially Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| For Profit - Corporation |
Non Profit - Corporation |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| Yes |
No |
| Resident and Family Councils |
| Both |
Resident |
| Continuing Care Retirement Community? |
| No |
No |
| Quality Indicator Survey? |
| No |
No |
| Special Focus Facility? |
| No |
No |
| Civil Money Penalty Count |
| 75.2 |
75.2 |
| Total Enforcement Actions Count |
| 75.2 |
75.2 |
| # of deficiencies |
| 3 |
|
|
| Staff Information |
| Number of Residents |
| 37 |
48 |
| Number of RN Hours Per Resident Per Day |
| 1.17 |
0.87 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 0.43 |
0.77 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.6 |
1.63 |
| Number of CNA Hours Per Resident Per Day |
| 0.13 |
0.04 |
| Number Therapy Hours Per Resident Per Day |
| 0.13 |
0.04 |
| Environmental Deficiencies |
| Deficiency #1 |
| Scope: Manylevel Of Harm: 1deficiency: Provide Housekeeping And Maintenance Services.survey Date: 04/05/2011date Of Correction: 05/05/2011 |
|
| Deficiency #2 |
| Scope: Somelevel Of Harm: 4deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 11/09/2010date Of Correction: 11/18/2010 |
|
| Administration Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Give Or Get Quality Lab Services/tests In A Timely Manner To Meet The Needs Of Residents.survey Date: 04/05/2011date Of Correction: 05/05/2011 |
|
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 28.6 % |
28.2 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 75.2 % |
75.2 % |
| Percent of long-stay residents who lose too much weight |
| 5.7 % |
17.1:1 |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 11.3 % |
75.2 % |
| Percent of long-stay residents with a urinary tract infection |
| 5.7 % |
7.3 % |
| Percent of long-stay residents who have depressive symptoms |
| 8.6:1 |
17.1:1 |
| Percent of long-stay residents who were physically restrained |
| 2.9 % |
4.9 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 95.7 % |
100 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 91.3 % |
95.2 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 75.2 |
|
| Percent of long-stay residents experiencing one or more falls with major injury |
| 75.2 % |
2.4 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 26.4 % |
27.4 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 75.2 % |
75.2 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 20.5 % |
5.3 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 75.2 % |
12.2 % |
| Percent of long-stay residents who lose too much weight |
| 5.5 % |
15.4 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 44.4 % |
33.3 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 9.1 % |
3.7 % |
| Percent of long-stay residents with a urinary tract infection |
| 4.5 % |
5.1 % |
| Percent of long-stay residents who have depressive symptoms |
| 10.3:1 |
6.8 % |
| Percent of long-stay residents who were physically restrained |
| 2.7 % |
5.1 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 75.2 % |
0.8 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 31 % |
6 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 89.9 % |
97.5 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 87.8 % |
94.6 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 75.2 % |
9.8 % |