St Dominic Villa
St Dominic Villa Information
| Facility Name | St Dominic Villa |
| Location | 2375 Sinsinawa Rd, Hazel Green, WI 53811 |
| County (SSA Code) | Grant (210) |
| Phone Number | 608-748-9814 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 62 |
| Average Number of Residents | 58 |
| CCRC Facility? | No |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Staff Quality Rating | |
| Registered Nurse Quality Rating |
| Abuse Flag | No |
| Sprinklers Installed | Yes |
| Located In Hospital | No |
| Resident Family Council | Resident |
| Provider Business Name | SINSINAWA NURSING INC |
| Ownership Type | Non profit - Church related |
| Date First Approved | 2000-12-08 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 1.77322 |
| Reported LPN Staffing Hours per Resident per Day | 0.03926 |
| Reported RN Staffing - Hours per Resident per Day | 1.2067 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 1.24596 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.01919 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.01479 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 1.94135 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.65679 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.31612 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 2.91426 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.30298 |
| Total Weighted Health Survey Score for three cycles | 8.667 |
| Rating cycle 1 Standard Survey Health Date | 2020-01-22 |
| Rating cycle 1 - Health Deficiency Score | 3 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-11-29 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-08-17 |
| Rating cycle 3 - Health Deficiency Score | 4 |
| Rating cycle 3 - Total Health Inspection Score | 4 |
| Number of Facility-Reported Incidents | 0 |
| Number of Substantiated Complaints | 0 |
| Number of Substantiated Complaints | 0 |
| Total Number of Penalties | 0 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |