Pine Mnr Hcc

1625 E MAIN ST

Clintonville, WI 54929

(715) 823-3135

General

Ratings

Deficiencies

Resident Stats

Staff Stats

Certified Beds:	95
Number of Residents:	62
Percent of Occupied Beds:	65%
Sprinkler Status:	Fully Sprinklered
Program Participation:	Medicare and Medicaid
Type of Ownership:	For profit - Corporation
Located Within a Hospital?	No
Multi Nursing Home Ownership?	Yes
Resident and Family Councils?	Resident
Continuing Care Retirement Community?	No
Quality Indicator Survey?	No
Special Focus Facility?	No

Date	Type	Category	Deficiency	Scope	Level of Harm	Date of Correction
20100210	Health	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Isolated	Minimal harm or potential for actual harm	20100310
20100210	Health	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm	20100310
20100817	Health	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Isolated	Minimal harm or potential for actual harm	20100903
20100817	Health	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Isolated	Minimal harm or potential for actual harm	20100903
20100817	Health	Mistreatment Deficiencies	1) Hire only people who have 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.	Pattern	Minimal harm or potential for actual harm	20100903
20100817	Health	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Minimal harm or potential for actual harm	20100903

	Value	Notes
Percent of long-stay residents given influenza vaccination during the flu season:	93
Percent of long-stay residents who were assessed and given pneumococcal vaccination:	83
Percent of long-stay residents whose need for help with daily activities has increased:	14
Percent of long-stay residents who have moderate to severe pain:	1
Percent of high-risk long-stay residents who have pressure sores:	10
Percent of low-risk long-stay residents who have pressure sores:	2
Percent of long-stay residents who were physically restrained:	9
Percent of long-stay residents who are more depressed or anxious:	24
Percent of low-risk long-stay residents who lose control of their bowels or bladder:	45
Percent of long-stay residents who have/had a catheter inserted and left in their bladder:	5
Percent of long-stay residents who spend most of their time in bed or in a chair:	2
Percent of long-stay residents whose ability to move about in and around their room got worse:	14
Percent of long-stay residents who had a urinary tract infection:	4
Percent of long-stay residents who lose too much weight:	8
Percent of short-stay residents given influenza vaccination during the flu season:	89
Percent of short-stay residents who were assessed and given pneumococcal vaccination:	75
Percent of short-stay residents who have delirium:	8
Percent of short-stay residents who had moderate to severe pain:	3
Percent of short-stay residents who have pressure sores:	11

# of Residents:	62
# RN Hours per Resident:	0.5
# LPN Hours per Resident:	0.76
# CNA Hours per Resident:	2.72
Total Staff Hours per Resident:	1.26

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