| General |
| City |
| Kenosha |
Sheboygan |
| State attribute explanation |
| Wi |
Wi |
| Street |
| 3415 N Sheridan Rd |
1902 Mead Ave |
| Zip Code |
| 53,140 |
53,081 |
| Phone |
| 2,626,576,175 |
9,204,588,333 |
|
Overall Star Rating |
| 3 |
3 |
|
Health Inspections Star Rating |
| 2 |
3 |
|
Nurse Staffing Star Rating |
| 4 |
2 |
|
Quality Measures Star Rating |
| 3 |
3 |
|
RN Only Star Rating |
| 4 |
3 |
|
Number of Certified Beds |
| 159 |
142 |
|
Total Number of Residents |
| 86 |
78 |
|
Percent of Occupied Beds |
| 54 % |
55 % |
| Health Survey Date |
| 1/19/2012 |
9/28/2011 |
| Fire Survey Date |
| 1/17/2012 |
10/10/2011 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| For Profit - Corporation |
For Profit - Corporation |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| Yes |
Yes |
| 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 |
| 6 |
75.2 |
| Total Enforcement Actions Count |
| 7 |
75.2 |
| # of deficiencies |
| 19 |
5 |
|
| Staff Information |
| Number of Residents |
| 86 |
78 |
| Number of RN Hours Per Resident Per Day |
| 0.75 |
0.69 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 0.74 |
0.82 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.49 |
1.51 |
| Number of CNA Hours Per Resident Per Day |
| 0.07 |
0.18 |
| Number Therapy Hours Per Resident Per Day |
| 0.07 |
0.18 |
| Environmental Deficiencies |
| Deficiency #1 |
| 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: 04/29/2010date Of Correction: 06/03/2010 |
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: 11/01/2011date Of Correction: 12/01/2011 |
| Deficiency #2 |
| Scope: Somelevel 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: 12/10/2009date Of Correction: 01/11/2010 |
|
| 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: 01/19/2012date Of Correction: 02/10/2012 |
|
| Deficiency #2 |
| Scope: Fewlevel Of Harm: 2deficiency: Keep Each Resident Free From Physical Restraints, Unless Needed For Medical Treatment.survey Date: 01/19/2012date Of Correction: 02/10/2012 |
|
| Deficiency #3 |
| Scope: Fewlevel Of Harm: 2deficiency: Develop Policies That Prevent Mistreatment, Neglect, Or Abuse Of Residents Or Theft Of Resident Property.survey Date: 04/29/2010date Of Correction: 06/03/2010 |
|
| Deficiency #4 |
| 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: 04/29/2010date Of Correction: 06/03/2010 |
|
| Resident Rights Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 4deficiency: Immediately Tell The Resident, The Resident's Doctor And A Family Member Of The Resident Of Situations (injury/decline/room, Etc.) That Affect The Resident.survey Date: 12/07/2010date Of Correction: 10/14/2010 |
|
| Deficiency #2 |
| Scope: Fewlevel Of Harm: 4deficiency: Immediately Tell The Resident, The Resident's Doctor And A Family Member Of The Resident Of Situations (injury/decline/room, Etc.) That Affect The Resident.survey Date: 12/10/2009date Of Correction: 01/11/2010 |
|
| Deficiency #3 |
| Scope: Fewlevel Of Harm: 2deficiency: Reasonably Accommodate The Needs And Preferences Of Each Resident.survey Date: 09/21/2009date Of Correction: 10/21/2009 |
|
| Quality Care Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 4deficiency: Give Residents Proper Treatment To Prevent New Bed (pressure) Sores Or Heal Existing Bed Sores.survey Date: 12/07/2010date Of Correction: 10/14/2010 |
Scope: Somelevel Of Harm: 1deficiency: Develop Policies And Procedures For Influenza And Pneumococcal Immunizations.survey Date: 07/01/2010date Of Correction: 08/01/2010 |
| Deficiency #2 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure That Residents With Reduced Range Of Motion Get Proper Treatment And Services To Increase Range Of Motion.survey Date: 12/10/2009date Of Correction: 01/11/2010 |
Scope: Fewlevel Of Harm: 2deficiency: Provide Necessary Care And Services To Maintain The Highest Well Being Of Each Resident .survey Date: 07/01/2010date Of Correction: 08/01/2010 |
| Deficiency #3 |
| Scope: Fewlevel Of Harm: 2deficiency: Give Residents Proper Treatment To Prevent New Bed (pressure) Sores Or Heal Existing Bed Sores.survey Date: 12/10/2009date Of Correction: 01/11/2010 |
Scope: Fewlevel Of Harm: 2deficiency: Provide Care By Qualified Persons According To Each Resident's Written Plan Of Care.survey Date: 07/01/2010date Of Correction: 08/01/2010 |
| Deficiency #4 |
| Scope: Fewlevel Of Harm: 4deficiency: Provide Necessary Care And Services To Maintain The Highest Well Being Of Each Resident .survey Date: 12/10/2009date Of Correction: 01/11/2010 |
|
| Deficiency #5 |
| Scope: Fewlevel Of Harm: 2deficiency: Properly Care For Residents Needing Special Services, Including: Injections, Colostomy, Ureostomy, Ileostomy, Tracheostomy Care, Tracheal Suctioning, Respiratory Care, Foot Care, And Prostheses.survey Date: 09/21/2009date Of Correction: 10/21/2009 |
|
| Pharmacy Service Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: 1) Make Sure That Each Resident's Drug Regimen Is Free From Unnecessary Drugs; 2) Each Resident's Entire Drug/medication Is Managed And Monitored To Achieve Highest Well Being.survey Date: 01/19/2012date Of Correction: 02/10/2012 |
Scope: Fewlevel Of Harm: 2deficiency: At Least Once A Month, Have A Licensed Pharmacist Review Each Resident's Medication(s) And Report Any Irregularities To The Attending Doctor.survey Date: 07/01/2010date Of Correction: 08/01/2010 |
| Deficiency #2 |
| 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: 06/03/2010date Of Correction: 06/11/2010 |
|
| Deficiency #3 |
| Scope: Fewlevel Of Harm: 2deficiency: Maintain Drug Records And Properly Mark/label Drugs And Other Similar Products According To Accepted Professional Standards.survey Date: 12/10/2009date Of Correction: 01/11/2010 |
|
| Deficiency #4 |
| Scope: Somelevel Of Harm: 2deficiency: 1) Make Sure That Each Resident's Drug Regimen Is Free From Unnecessary Drugs; 2) Each Resident's Entire Drug/medication Is Managed And Monitored To Achieve Highest Well Being.survey Date: 12/10/2009date Of Correction: 01/11/2010 |
|
| Nutrition and Dietary Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Prepare Food That Is Nutritional, Appetizing, Tasty, Attractive, Well-cooked, And At The Right Temperature.survey Date: 09/21/2009date Of Correction: 10/21/2009 |
|
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 11 % |
25.9 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 5.2 % |
1.4 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 13.9 / 15.3 |
14.4 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 10.3:1 |
4.2 % |
| Percent of long-stay residents who lose too much weight |
| 8.9 / 9.9 |
6.9 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 42.9 % |
61.9 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 4.8 % |
75.2 % |
| Percent of long-stay residents with a urinary tract infection |
| 6.3 % |
3.4 % |
| Percent of long-stay residents who have depressive symptoms |
| 5 % |
10.5 % |
| Percent of long-stay residents who were physically restrained |
| 1.3 % |
75.2 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 24 % |
43.4 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 96.7 % |
93 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 95 % |
94.6 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 75.2 % |
75.2 |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 3.8 % |
3.4 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 9.5 % |
19.1:1 |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 3.3 % |
3.1 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 18.4 % |
14.1 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 8.8 % |
4.3 % |
| Percent of long-stay residents who lose too much weight |
| 8.5 % |
5.3 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 39.8 % |
60.2 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 4.4 % |
75.2 % |
| Percent of long-stay residents with a urinary tract infection |
| 6.9 % |
3.5 % |
| Percent of long-stay residents who have depressive symptoms |
| 7.2 % |
8.9 / 9.9 |
| Percent of long-stay residents who were physically restrained |
| 1.2 % |
75.2 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 2.8 % |
4.1 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 24.6 % |
35.7 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 81.5 % |
92.3 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 83.9 % |
95.8 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 10.1:1 |
21.9 % |