Provider Name: DOOR COUNTY MEMORIAL HOSPITAL SNF
Address: 323 S 18TH AVE, STURGEON BAY, WI 54235
Phone: (920) 743-5566
County: Door (140)
Ownership Type: Non profit - Corporation
Certified Beds: 32
Average Residents Per Day: 28.4 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: DOOR COUNTY MEMORIAL HOSPITAL
First Approved Date: October 1, 1984
Affiliated Entity: ()
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Resident
Sprinkler System Status: Yes
Overall Rating: 4 ()
Health Inspection Rating: 5 ()
QM Rating: 1 ()
Long Stay QM Rating: 1 ()
Short Stay QM Rating: (2)
Staffing Rating: 5 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.31061, LPN Staff Hours Per Day: 0.4792, RN Staff Hours Per Day: 2.3197, Licensed Staff Hours Per Day: 2.7989
Total Nurse Staff Hours Per Day, per resident: 5.10960
Weekend Nurse Staff Hours: 4.70957, Weekend RN Staff Hours: 1.7959
PT Staff Hours Per Day, per resident: 0.0059
Nurse Staff Turnover: 31.8, Nurse Turnover Note:
RN Turnover: 11.1, RN Turnover Note:
Admin Left Number: 0, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.0031, Case Mix LPN Hours Per Day: 0.6398, Case Mix RN Hours Per Day: 0.2383
Adjusted Nurse Aide Hours Per Day, per resident: 2.34991, Adjusted LPN Hours Per Day: 0.5527, Adjusted RN Hours Per Day: 3.6667
Total Adjusted Nurse Hours Per Day, per resident: 5.58944
Adjusted Weekend Nurse Hours Per Day, per resident: 5.15185
Health Survey Dates and Scores: Cycle 1: 2022-11-09 (Score: 8), Cycle 2: 2021-10-06 (Score: 0), Cycle 3: 2020-02-19 (Score: 0)
Total Weighted Health Score: 4.000
Reported Incidents: 1, Substantiated Complaints: 0
Infection Control Citations:
Fines and Penalties: Number of Fines: 0, Total Fines in Dollars: 0.00, Payment Denials Number: 0, Total Penalties Number: 0
Location and GPS: 323 S 18TH AVE,STURGEON BAY,WI,54235 (44.8326, -87.351)
Process Date: 2024-03-01
Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Health, Deficiency: Respond appropriately to all alleged violations.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2024-02-12
Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Fire Safety, Tag: 0918, Version: New
Description: Have generator or other power source capable of supplying service within 10 seconds.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2021-10-07
Type: Fire Safety, Tag: 0372, Version: New
Description: Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2020-02-27
Type: Fire Safety, Tag: 0918, Version: New
Description: Have generator or other power source capable of supplying service within 10 seconds.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2020-03-13