PINE MANOR HEALTH CARE CTR 3052 - CLINTONVILLE, WI

United States hospital / nursing home:
PINE MANOR HEALTH CARE CTR 3052 - CLINTONVILLE, WI

PINE MANOR HEALTH CARE CTR 3052
ROUTE 4 PO BOX 549
CLINTONVILLE, WI 54929

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

Services provided by PINE MANOR HEALTH CARE CTR 3052:

  • 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
  • Nursing services are provided onsite to residents
  • Occupational therapy services are provided onsite to non residents
  • Occupational therapy services are provided onsite to residents
  • Field 1 - Indicates other activity services provided by 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 non 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 non residents
  • Speech/language pathology services are provided onsite to residents
  • Therapeutic recreation specialist 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): 81

Beds - Total certified (Number of beds in Medicare and/or Medicaid certified areas within a facility): 81

Lpn/lvn - Full time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a full time basis): 3.96

Registered nurse - Full time (The number of full-time equivalent registered nurses employed by a facility on a full time basis): 0.83

Change of ownership counter (The number of times a change of ownership (chow) has taken place for a particular provider): 2

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

Prior change of ownership (The date of a prior change of ownership): Nov 2000

Compliance: life safety code (Indicates if a waiver of the life safety code has been recommended for a provider): WAIVER RECOMMENDED

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

Administrator - Full time (The number of full-time equivalent administrative staff employed on a full time basis by a facility): 1

Beds - Snf/nf (Number of beds certified for both Medicare and Medicaid skilled nursing care in a long term care facility): 81

Cert nurse aides - Contract (The number of full-time equivalent certified nurse aides under contract to a facility): 1.83

Cert nurse aides - Full time (The number of full-time equivalent certified nurse aides employed by a facility on a full time basis): 21.56

Cert nurse aides - Part time (The number of full-time equivalent certified nurse aides employed by a facility on a part time basis): 6.77

Dentists - Contract (The number of full-time equivalent dentists under contract to a facility): 0.01

Dietitians - Contract (The number of full-time equivalent under contract to a facility): 0.06

Food service - Full time (The number of full-time equivalent food service personnel employed by a facility on a full time basis): 4.84

Food service - Part time (The number of full-time equivalent food service personnel employed by a facility on a part time basis): 4.87

Housekeeping - Full time (The number of full-time equivalent housekeeping personnel employed by a facility on a full time basis): 1.07

Housekeeping - Part time (The number of full-time equivalent housekeeping personnel employed by a facility on a part time basis): 1.97

Lpn/lvn - Part time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a part time basis): 1.30

Medical director - Contract (The number of full-time equivalent medical directors under contrcat to a facility): 0.01

Multi-Facility organization name (The name of the multi-Facility organization that owns the facility): FIVE STAR QUALITY CARE INC

Multi-Facility organization owned (Indicates if a facility is owned by an organization that owns (or leases) two or more nursing facilities): Yes

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): 1.34

Occup therapy asst - Part time (The number of full-time equivalent occupational therapy assistants employed by a facility on a part time basis): 0.23

Occupational therapist - Part time (The number of full-time equivalent occupational therapists employed by a facility on a part time basis): 0.07

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): 3.74

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): 3.11

Other activities staff-Full time (Number of full-time staff hours for other activities): 1.07

Other activities staff-Part time (Number of part time staff hours provided by other activ ities staff): 2.53

Other physician - Contract (The number of full-time equivalent other physicians under contract to a facility): 0.06

Pharmacists - Contract (The number of full-time equivalent pharmacists under contract to a facility): 0.01

Phys ther asst - Part time (Number of part-time staff hours for physical therapy as sistants): 0.37

Physical therapists - Part time (The number of full-time equivalent physical therapists employed by a facility on a part time basis): 0.03

Physician extender - Contract (The number of full-time equivalent physician extenders under contract to the facility): 0.01

Podiatrists - Contract (The number of full time equivalent podiatrists under contract to a facility): 0.01

Registered nurse - Contract (The number of full-time equivalent registered nurses under contract to a facility): 0.46

Registered nurse - Part time (The number of full-time equivalent registered nurses employed by a facility on a part time basis): 1.56

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

Social worker - Part time (The number of full-time equivalent social workers employed by a facility on a part time basis): 1.24

Special care beds-Alzheimers (The number of beds in a unit identified and dedicated by the facility for residents with alzeheimers): 36

Speech pathologist - Part time (The number of full-time equivalent speech pathologists employed by a facility on a part time basis): 0.13

Ther rec spec - Full time (Number of full-time staff hours provided by therapeutic recreation specialist): 2.29

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): Aug 2001

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): Nov 1992