SOUTH SHORE MANOR - BAYVIEW, WI
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Back to Hospital Data. Institution representatives - add corrected or new information about SOUTH SHORE MANOR » SOUTH SHORE MANOR1915 E TRIPOLI AVENUE BAYVIEW, WI 53235 RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTIONS SNF/NF (DUALLY CERTIFIED) Services provided by SOUTH SHORE MANOR:
Beds - Total (Total number of beds in a facility, including those in non-Participating or non-licensed areas): 34 Beds - Total certified (Number of beds in Medicare and/or Medicaid certified areas within a facility): 34 Lpn/lvn - Full time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a full time basis): 2.33 Registered nurse - Full time (The number of full-time equivalent registered nurses employed by a facility on a full time basis): 1.21 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 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): 2.40 Beds - Snf/nf (Number of beds certified for both Medicare and Medicaid skilled nursing care in a long term care facility): 34 Cert nurse aides - Full time (The number of full-time equivalent certified nurse aides employed by a facility on a full time basis): 11.17 Cert nurse aides - Part time (The number of full-time equivalent certified nurse aides employed by a facility on a part time basis): 1.23 Dentists - Contract (The number of full-time equivalent dentists under contract to a facility): 0.03 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): 3.56 Food service - Part time (The number of full-time equivalent food service personnel employed by a facility on a part time basis): 0.44 Housekeeping - Contract (The number of full-time equivalent housekeeping personnel under contract to a facility): 3.43 Lpn/lvn - Part time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a part time basis): 1.36 Medical director - Contract (The number of full-time equivalent medical directors under contrcat to a facility): 0.04 Mental health services - Contract (The number of full-time equivalent mental health services personnel under contract to a facility): 0.09 Multi-Facility organization name (The name of the multi-Facility organization that owns the facility): BEVERLY ENTERPRISES Multi-Facility organization owned (Indicates if a facility is owned by an organization that owns (or leases) two or more nursing facilities): Yes Occupational therapist - Contract (The number of full-time equivalent occupational therapists under contract to a facility): 0.57 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): 1.04 Othr social serv staff-Full time (Number of full-time staff hours provided by other socia l services staff): 1 Pharmacists - Contract (The number of full-time equivalent pharmacists under contract to a facility): 0.06 Physical therapists - Contract (The number of full-time equivalent physical therapists under contract to a facility): 0.57 Registered nurse - Part time (The number of full-time equivalent registered nurses employed by a facility on a part time basis): 1.01 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 - Part time (The number of full-time equivalent social workers employed by a facility on a part time basis): 0.11 Speech pathologist - Contract (The number of full-time equivalent speech pathologists under contract to a facility): 0.29 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): Jun 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): Nov 1991 |
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