Maryhill Manor
501 Madison Ave, Niagara, WI 54151


Maryhill Manor is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 525467. The address is 501 Madison Ave, Niagara, WI 54151. The zip code is 54151. The phone number is 7152513172.


Maryhill Manor · 501 Madison Ave, Niagara, WI 54151

Federal Provider Number 525467
Provider Name MARYHILL MANOR
Address 501 MADISON AVE
NIAGARA, WI 54151
Phone Number 7152513172
SSA County Code 370
County Name Marinette
Ownership Type Non profit - Church related
Certified Beds 75
Certified Beds Residents 64
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name MARYHILL MANOR INC
Date First Approved to Provide Medicare Medicaid Services 06/01/1990
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 5
Health Inspection Rating 3
Quality Measure Rating 5
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 2.64922
Reported LPN Staffing Hours per Resident per Day 0.51406
Reported RN Staffing Hours per Resident per Day 0.83281
Reported Licensed Staffing Hours per Resident per Day 1.34688
Reported Total Nurse Staffing Hours per Resident per Day 3.99609
Reported Physical Therapist Staffing Hours per Resident Per Day 0.04219
Expected CNA Staffing Hours per Resident per Day 2.60039
Expected LPN Staffing Hours per Resident per Day 0.64255
Expected RN Staffing Hours per Resident per Day 0.93611
Expected Total Nurse Staffing Hours per Resident per Day 4.17905
Adjusted CNA Staffing Hours per Resident per Day 2.49977
Adjusted LPN Staffing Hours per Resident per Day 0.66403
Adjusted RN Staffing Hours per Resident per Day 0.66475
Adjusted Total Nurse Staffing Hours per Resident per Day 3.85443
Cycle 1 Total Number of Health Deficiencies 6
Cycle 1 Number of Standard Health Deficiencies 6
Cycle 1 Health Deficiency Score 28
Cycle 1 Standard Survey Health Date 06/08/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 28
Cycle 2 Total Number of Health Deficiencies 8
Cycle 2 Number of Standard Health Deficiencies 6
Cycle 2 Number of Complaint Health Deficiencies 3
Cycle 2 Health Deficiency Score 64
Cycle 2 Standard Health Survey Date 04/14/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 64
Cycle 3 Total Number of Health Deficiencies 11
Cycle 3 Number of Standard Health Deficiencies 11
Cycle 3 Health Deficiency Score 56
Cycle 3 Standard Health Survey Date 03/05/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 56
Total Weighted Health Survey Score 44.667
Number of Facility Reported Incidents 1
Number of Substantiated Complaints 1
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Maryhill Manor

Owner Name Role Association Date
BAIER, PATRICIA (Individual) DIRECTOR since 01/01/2016
CANAVERA, LEILA (Individual) DIRECTOR since 01/01/2016
EBLI, JIM (Individual) DIRECTOR since 01/01/2016
FRANTZ, LANA (Individual) DIRECTOR since 01/01/2016
HERRIGES, ROSEMARY (Individual) DIRECTOR since 01/01/2016
MCROBERTS, HENRY (Individual) DIRECTOR since 01/01/2016
PRYOR, JON (Individual) DIRECTOR since 01/01/2016
PULTZ, ROBERT (Individual) DIRECTOR since 01/01/2016
ROEHRIG, JOAN (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 05/16/2011
ROEHRIG, JOAN (Individual) DIRECTOR since 05/16/2011
ROEHRIG, JOAN (Individual) MANAGING EMPLOYEE since 05/16/2011
SETTLE, MATT (Individual) DIRECTOR since 01/01/2016
THORNBERRY, ALLYN (Individual) DIRECTOR since 01/01/2016

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