Brewster Village
3300 W Brewster St, Appleton, WI 54914


Brewster Village is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 525574. The address is 3300 W Brewster St, Appleton, WI 54914. The zip code is 54914. The phone number is 9208325400.


Brewster Village · 3300 W Brewster St, Appleton, WI 54914

Federal Provider Number 525574
Provider Name BREWSTER VILLAGE
Address 3300 W BREWSTER ST
APPLETON, WI 54914
Phone Number 9208325400
SSA County Code 430
County Name Outagamie
Ownership Type Government - County
Certified Beds 204
Certified Beds Residents 184
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name COUNTY OF OUTAGAMIE
Date First Approved to Provide Medicare Medicaid Services 08/01/1995
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 5
Quality Measure Rating 3
Staffing Rating 5
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 3.10978
Reported LPN Staffing Hours per Resident per Day 0.1212
Reported RN Staffing Hours per Resident per Day 1.21087
Reported Licensed Staffing Hours per Resident per Day 1.33207
Reported Total Nurse Staffing Hours per Resident per Day 4.44185
Reported Physical Therapist Staffing Hours per Resident Per Day 0.02962
Expected CNA Staffing Hours per Resident per Day 2.3915
Expected LPN Staffing Hours per Resident per Day 0.59518
Expected RN Staffing Hours per Resident per Day 0.88645
Expected Total Nurse Staffing Hours per Resident per Day 3.87313
Adjusted CNA Staffing Hours per Resident per Day 3.19066
Adjusted LPN Staffing Hours per Resident per Day 0.16902
Adjusted RN Staffing Hours per Resident per Day 1.02066
Adjusted Total Nurse Staffing Hours per Resident per Day 4.62278
Cycle 1 Total Number of Health Deficiencies 2
Cycle 1 Number of Standard Health Deficiencies 2
Cycle 1 Health Deficiency Score 12
Cycle 1 Standard Survey Health Date 11/09/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 12
Cycle 2 Total Number of Health Deficiencies 3
Cycle 2 Number of Standard Health Deficiencies 2
Cycle 2 Number of Complaint Health Deficiencies 1
Cycle 2 Health Deficiency Score 24
Cycle 2 Standard Health Survey Date 09/21/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 24
Cycle 3 Standard Health Survey Date 09/29/2014
Total Weighted Health Survey Score 14
Number of Substantiated Complaints 1
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Brewster Village

Owner Name Role Association Date
COUNTY OF OUTAGAMIE (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 03/15/2010
DAVIS, ROSEMARY (Individual) MANAGING EMPLOYEE since 03/15/2010
HINKLEY, MORGAN (Individual) MANAGING EMPLOYEE since 06/01/2015
SCHROEDER, AMBER (Individual) OPERATIONAL/MANAGERIAL CONTROL since 08/01/2015

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