BLOOMFIELD MANOR NURSING HOME - DODGEVILLE, WI

United States hospital / nursing home:
BLOOMFIELD MANOR NURSING HOME - DODGEVILLE, WI

BLOOMFIELD MANOR NURSING HOME
3151 COUNTY ROAD CH
DODGEVILLE, WI 53533


RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTIONS SNF/NF (DUALLY CERTIFIED)

Services provided by BLOOMFIELD MANOR NURSING HOME:

  • Activities services are provided onsite to residents
  • Administration and storage of blood services are provided offsite to residents
  • Clinical laboratory services are provided offsite to residents
  • Dental services are provided onsite to residents
  • Dietary services are provided onsite to residents
  • Housekeeping services are provided onsite to residents
  • Mental health services are provided offsite to residents
  • Nursing services are provided onsite to residents
  • Occupational therapy services are provided onsite to residents
  • Field 1 - Indicates other activity services provided by staff onsite to residents
  • Field 1 - Indicates services provided by social service s staff onsite to residents
  • Pharmacy services are provided onsite to residents
  • Physician extender services are provided onsite to residents
  • Physical therapy services are provided onsite to residents
  • Physician services are provided onsite to residents
  • Podiatry services are provided onsite to residents
  • Social work services are provided onsite to residents
  • Speech/language pathology services are provided onsite to residents
  • Therapeutic recreation specialist services are provided onsite to residents
  • Vocational services are provided offsite to residents
  • Diagnostic xray services are provided offsite to residents

Beds - Total (Total number of beds in a facility, including those in non-Participating or non-licensed areas): 92

Beds - Total certified (Number of beds in Medicare and/or Medicaid certified areas within a facility): 92

Lpn/lvn - Full time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a full time basis): 2.19

Registered nurse - Full time (The number of full-time equivalent registered nurses employed by a facility on a full time basis): 6.54

Current fms survey date (Current fms survey date): Jun 2001

Program participation (Indicates if the provider participates in Medicare, Medicaid, or both programs): MEDICARE AND MEDICAID

Regional override #1 (number beds) (This field is set to "y" when the regional office has to ok a pending record in the special fields screen. this field only applies to categories in the odie data entry system): Yes

Regional override #2 (staffing) (This field is set to "y" when the regional office has to ok a pending record in the special fields screen. this field only applies to categories in the odie data entry system): Yes

Activity professional - Full time (The number of full-time equivalent activities professionals employed full time by a facility): 1.14

Administrator - Full time (The number of full-time equivalent administrative staff employed on a full time basis by a facility): 2.74

Administrator - Part time (The number of full-time equivalent administrative staff employed on a part-time basis by a facility): 0.69

Beds - Snf/nf (Number of beds certified for both Medicare and Medicaid skilled nursing care in a long term care facility): 92

Cert nurse aides - Full time (The number of full-time equivalent certified nurse aides employed by a facility on a full time basis): 26.03

Cert nurse aides - Part time (The number of full-time equivalent certified nurse aides employed by a facility on a part time basis): 11.76

Dietitians - Contract (The number of full-time equivalent under contract to a facility): 0.19

Food service - Full time (The number of full-time equivalent food service personnel employed by a facility on a full time basis): 4.31

Food service - Part time (The number of full-time equivalent food service personnel employed by a facility on a part time basis): 4.71

Housekeeping - Full time (The number of full-time equivalent housekeeping personnel employed by a facility on a full time basis): 1.11

Housekeeping - Part time (The number of full-time equivalent housekeeping personnel employed by a facility on a part time basis): 3.59

Lpn/lvn - Part time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a part time basis): 0.63

Medical director - Contract (The number of full-time equivalent medical directors under contrcat to a facility): 0.06

Medication aides/techs-Part time (The number of full-time equivalent medication aides/ technicians employed bya facility on a part time basis): 0.37

Nurse aides in trng-Part time (The number of full-time equivalent nurse aides in training employed by a facility on a part time basis): 1.09

Nurses with admin duties-Full time (The number of full-time equivalent nurses with administrative duties employed by a facility on a full time basis): 1.14

Occupational therapist - Contract (The number of full-time equivalent occupational therapists under contract to a facility): 0.91

Organized family group (Indicates if the facility has an organized group of family members of residents): Yes

Organized resident group (Indicates if the facility has an organized residents group): Yes

Other - Full time (The number of full-time equivalent persons not included in any other categories employed by the facility on a full-time basis): 3.09

Other - Part time (The number of full-time equivalent persons not included in any other categories employed by the facility on a part-time basis): 2.14

Other activities staff-Full time (Number of full-time staff hours for other activities): 1.13

Other activities staff-Part time (Number of part time staff hours provided by other activ ities staff): 1.26

Other physician - Contract (The number of full-time equivalent other physicians under contract to a facility): 0.03

Physical therapists - Contract (The number of full-time equivalent physical therapists under contract to a facility): 1.26

Registered nurse - Part time (The number of full-time equivalent registered nurses employed by a facility on a part time basis): 3.86

Rn director of nursing - Full time (The number of full-time equivalent rn director of nursing employed by a facility on a full time basis): 1.14

Social worker - Contract (The number of full-time equivalent social workers under contract to a facility): 0.04

Social worker - Full time (The number of full-time equivalent social workers employed by a facility on a full time basis): 1.09

Special care beds-Alzheimers (The number of beds in a unit identified and dedicated by the facility for residents with alzeheimers): 26

Speech pathologist - Contract (The number of full-time equivalent speech pathologists under contract to a facility): 0.03

Compliance: plan of correction (Indicates if a provider is in compliance with program requirements based on an acceptable plan for correction of deficiencies): COMPLIANCE BASED ON ACCEPTABLE POC

Compliance: status (Indicates if a provider or supplier is in compliance with program requirements): IN COMPLIANCE

Current survey date (The date of the health or life safety code survey, whichever is later. the "official" survey date for the provider): May 2002

Eligibility code (Indicates if a facility is eligible to participate in the Medicare and/or Medicaid programs): ELIGIBLE TO PARTICIPATE

Participation date (The date a facility is first approved to provide Medicare and/or Medicaid services): Aug 1991