| General |
| City |
| Kenosha |
Spring Valley |
| State attribute explanation |
| Wi |
Wi |
| Street |
| 1703 60th St |
S830 - Westland Dr |
| Zip Code |
| 53,140 |
54,767 |
| Phone |
| 2,626,584,125 |
7,157,785,545 |
|
Overall Star Rating |
| 1 |
5 |
|
Health Inspections Star Rating |
| 1 |
4 |
|
Nurse Staffing Star Rating |
| 3 |
5 |
|
Quality Measures Star Rating |
| 4 |
4 |
|
RN Only Star Rating |
| 5 |
5 |
|
Number of Certified Beds |
| 97 |
50 |
| Total Number of Residents |
| 75 |
39 |
|
Percent of Occupied Beds |
| 77 % |
78 % |
| Health Survey Date |
| 10/4/2011 |
5/5/2011 |
| Fire Survey Date |
| 10/4/2011 |
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 |
| Resident |
Resident |
| Continuing Care Retirement Community? |
| No |
No |
| Quality Indicator Survey? |
| No |
No |
| Special Focus Facility? |
| No |
No |
| Civil Money Penalty Count |
| 2 |
75.2 |
| Total Enforcement Actions Count |
| 3 |
75.2 |
| # of deficiencies |
| 21 |
|
|
| Staff Information |
| Number of Residents |
| 75 |
48 |
| Number of RN Hours Per Resident Per Day |
| 0.96 |
0.87 |
| Number of LPN/LVN Hours Per Resident Per Day |
|
0.77 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 0.96 |
1.63 |
| Number of CNA Hours Per Resident Per Day |
| 0.04 |
0.04 |
| Number Therapy Hours Per Resident Per Day |
| 0.04 |
0.04 |
| Environmental Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Have A Program That Investigates, Controls And Keeps Infection From Spreading.survey Date: 04/03/2012date Of Correction: 04/03/2012 |
|
| Deficiency #2 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 04/03/2012date Of Correction: 04/03/2012 |
|
| Deficiency #3 |
| Scope: Fewlevel Of Harm: 2deficiency: Provide Housekeeping And Maintenance Services.survey Date: 04/03/2012date Of Correction: 04/03/2012 |
|
| Deficiency #4 |
| Scope: Manylevel Of Harm: 2deficiency: Have A Program That Investigates, Controls And Keeps Infection From Spreading.survey Date: 03/06/2012date Of Correction: 04/03/2012 |
|
| Deficiency #5 |
| Scope: Fewlevel 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: 03/06/2012date Of Correction: 04/03/2012 |
|
| Deficiency #6 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 05/23/2011date Of Correction: 06/23/2011 |
|
| Deficiency #7 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 07/08/2010date Of Correction: 08/08/2010 |
|
| Deficiency #8 |
| Scope: Fewlevel Of Harm: 3deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 10/28/2009date Of Correction: Not Available |
|
| Mistreatment Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: 1) Hire Only People With No Legal History Of Abusing, Neglecting Or Mistreating Residents; Or 2) Report And Investigate Any Acts Or Reports Of Abuse, Neglect Or Mistreatment Of Residents.survey Date: 03/06/2012date Of Correction: 04/03/2012 |
|
| Deficiency #2 |
| Scope: Manylevel Of Harm: 1deficiency: Develop Policies That Prevent Mistreatment, Neglect, Or Abuse Of Residents Or Theft Of Resident Property.survey Date: 01/18/2012date Of Correction: 02/15/2012 |
|
| Resident Rights Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Provide Care For Residents In A Way That Keeps Or Builds Each Resident's Dignity And Respect Of Individuality.survey Date: 10/04/2011date Of Correction: 11/04/2011 |
|
| Deficiency #2 |
| Scope: Somelevel Of Harm: 2deficiency: Provide Care For Residents In A Way That Keeps Or Builds Each Resident's Dignity And Respect Of Individuality.survey Date: 10/28/2009date Of Correction: Not Available |
|
| Quality Care Deficiencies |
| Deficiency #1 |
| Scope: Somelevel Of Harm: 2deficiency: Give Each Resident Enough Fluids To Keep Them Healthy And Prevent Dehydration.survey Date: 10/28/2010date Of Correction: 11/28/2010 |
|
| Deficiency #2 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure Services Provided By The Nursing Facility Meet Professional Standards Of Quality.survey Date: 10/28/2010date Of Correction: 11/28/2010 |
|
| Deficiency #3 |
| Scope: Somelevel Of Harm: 2deficiency: Develop Policies And Procedures For Influenza And Pneumococcal Immunizations.survey Date: 10/28/2009date Of Correction: Not Available |
|
| Deficiency #4 |
| Scope: Fewlevel Of Harm: 2deficiency: Provide Necessary Care And Services To Maintain The Highest Well Being Of Each Resident .survey Date: 10/28/2009date Of Correction: Not Available |
|
| Deficiency #5 |
| Scope: Fewlevel Of Harm: 2deficiency: Provide Medically-related Social Services To Help Each Resident Achieve The Highest Possible Quality Of Life.survey Date: 10/28/2009date Of Correction: Not Available |
|
| Deficiency #6 |
| Scope: Somelevel Of Harm: 2deficiency: Provide Activities To Meet The Interests And Needs Of Each Resident.survey Date: 10/28/2009date Of Correction: Not Available |
|
| Resident Assessment Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Develop A Complete Care Plan That Meets All Of A Resident's Needs, With Timetables And Actions That Can Be Measured.survey Date: 05/23/2011date Of Correction: 06/23/2011 |
|
| Administration Deficiencies |
| Deficiency #1 |
| Scope: Manylevel Of Harm: 2deficiency: 1) Review The Work Of Each Nurse Aide Every Year; And 2) Give Regular In-service Training Based Upon These Reviews.survey Date: 03/06/2012date Of Correction: 04/03/2012 |
|
| Pharmacy Service Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Safely Provide Drugs And Other Similar Products Available, Which Are Needed Every Day And In Emergencies, By A Licensed Pharmacist.survey Date: 03/06/2012date Of Correction: 04/03/2012 |
|
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 25.4 % |
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 self-report moderate to severe pain |
| 15.1 % |
|
| Percent of long-stay high-risk residents with pressure ulcers |
| 2.6 / 3 |
|
| Percent of long-stay residents who lose too much weight |
| 12.2 % |
17.1:1 |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 1.8 % |
75.2 % |
| Percent of long-stay residents with a urinary tract infection |
| 5.4 % |
7.3 % |
| Percent of long-stay residents who have depressive symptoms |
| 14.9-28 |
17.1:1 |
| Percent of long-stay residents who were physically restrained |
| 1.4 % |
4.9 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 21.7 % |
|
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 88.9 % |
100 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 81.6 % |
95.2 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 1 |
|
| Percent of long-stay residents experiencing one or more falls with major injury |
| 5.4 % |
2.4 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 28.3 % |
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 |
| 11.1 % |
5.3 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 4.6 % |
12.2 % |
| Percent of long-stay residents who lose too much weight |
| 11.7 % |
15.4 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 34.5 % |
33.3 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 1.8 % |
3.7 % |
| Percent of long-stay residents with a urinary tract infection |
| 5.3 % |
5.1 % |
| Percent of long-stay residents who have depressive symptoms |
| 10.6 % |
6.8 % |
| Percent of long-stay residents who were physically restrained |
| 0.5 - 2.0 |
5.1 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 3.8 % |
0.8 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 27 % |
6 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 80.4 % |
97.5 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 72.2 % |
94.6 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 2.1 % |
9.8 % |