DOOR COUNTY MEMORIAL HOSPITAL - STURGEON BAY, WI

United States hospital / nursing home:
DOOR COUNTY MEMORIAL HOSPITAL - STURGEON BAY, WI

DOOR COUNTY MEMORIAL HOSPITAL
323 SOUTH 18TH AVENUE
STURGEON BAY, WI 54235

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

Services provided by DOOR COUNTY MEMORIAL HOSPITAL:

• Activities services are provided onsite to residents
• Administration and storage of blood services are provided onsite to residents
• Clinical laboratory services are provided onsite 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 onsite 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
• 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 onsite to residents
• Diagnostic xray services are provided onsite to residents

Beds - Total (Total number of beds in a facility, including those in non-Participating or non-licensed areas): 30

Beds - Total certified (Number of beds in Medicare and/or Medicaid certified areas within a facility): 30

Lpn/lvn - Full time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a full time basis): 1.03

Registered nurse - Full time (The number of full-time equivalent registered nurses employed by a facility on a full time basis): 1.14

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

Related provider number (This field is used when a provider's facility contains more than one distinct provider,such as a hospital with distinct part long term care. the number in this field will be the provider nmbr of the highest level of care): 520152

Activity professional - Part time (The number of full-time equivalent activities professionals employed part time by a facility): 0.81

Administrator - Part time (The number of full-time equivalent administrative staff employed on a part-time basis by a facility): 0.57

Beds - Snf/nf (Number of beds certified for both Medicare and Medicaid skilled nursing care in a long term care facility): 30

Cert nurse aides - Full time (The number of full-time equivalent certified nurse aides employed by a facility on a full time basis): 3.33

Cert nurse aides - Part time (The number of full-time equivalent certified nurse aides employed by a facility on a part time basis): 4.91

Dietitians - Part time (The number of full-time equivalent dietitians employed by a facility on a part time basis): 0.23

Food service - Full time (The number of full-time equivalent food service personnel employed by a facility on a full time basis): 1.14

Food service - Part time (The number of full-time equivalent food service personnel employed by a facility on a part time basis): 2.86

Housekeeping - Full time (The number of full-time equivalent housekeeping personnel employed by a facility on a full time basis): 1.14

Housekeeping - Part time (The number of full-time equivalent housekeeping personnel employed by a facility on a part time basis): 0.46

Lpn/lvn - Part time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a part time basis): 3.31

Occupational therapist - Full time (The number of full-time equivalent occupational therapists employed by a facility on a full time basis): 0.01

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): 0.90

Pharmacists - Part time (The number of full-time equivalent pharmacists employed by a facility on a part time basis): 0.06

Phys ther asst - Full time (Number of full-time staff hours for physical therapy as sistants): 0.01

Physical therapists - Full time (The number of full time equivalent physical therapists employed by a facility on a full time basis): 0.01

Provider based facility (Indicates if a long term care facility is provider based): Yes

Registered nurse - Part time (The number of full-time equivalent registered nurses employed by a facility on a part time basis): 1.49

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): 0.57

Social worker - Part time (The number of full-time equivalent social workers employed by a facility on a part time basis): 0.63

Ther rec spec - Part time (Number of part-time staff hours provided by therapeutic recreation specialist): 0.29

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): Sep 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): Oct 1984

Quality Measure Score