Pine Haven Christian Home
Pine Haven Christian Home Information
| Facility Name | Pine Haven Christian Home |
| Location | 220 Haven Drive, Sheboygan Falls, WI 53085 |
| County (SSA Code) | Sheboygan (580) |
| Phone Number | 920-467-2401 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 50 |
| Average Number of Residents | 38.6 |
| CCRC Facility? | No |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Short 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 | PINE HAVEN CHRISTIAN HOME INC |
| Ownership Type | Non profit - Corporation |
| Date First Approved | 2004-03-05 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 2.99642 |
| Reported LPN Staffing Hours per Resident per Day | 0.986 |
| Reported RN Staffing - Hours per Resident per Day | 1.24184 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 2.22784 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 5.22426 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.10977 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.34722 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.74298 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.39362 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.48381 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.78095 |
| Total Weighted Health Survey Score for three cycles | 31.333 |
| Rating cycle 1 Standard Survey Health Date | 2020-01-15 |
| Rating cycle 1 - Health Deficiency Score | 2 |
| Rating cycle 1 - Total Health Inspection Score | 48 |
| Date of Rating cycle 2 Standard Health Survey Date | 2019-04-04 |
| Rating cycle 2 - Health Deficiency Score | 48 |
| Date of Rating cycle 3 Standard Health Survey Date | 2018-02-08 |
| Rating cycle 3 - Health Deficiency Score | 32 |
| Rating cycle 3 - Total Health Inspection Score | 32 |
| Number of Facility-Reported Incidents | 0 |
| Number of Substantiated Complaints | 1 |
| Number of Substantiated Complaints | 1 |
| Total Number of Penalties | 0 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |