General Information: ATTIC ANGEL PLACE HEALTH CENTER
Nursing home name ATTIC ANGEL PLACE HEALTH CENTER
Address8301 OLD SAUK RD
MIDDLETON, WI 53562
Phone number (608) 662-8842
Located within a hospital No
Type of ownership Non profit - Corporation
Owner operates multiple homesNo
Accept Medicare or Medicaid Medicare
Continue Care Retirement CommunityYes
Resident and family councils Resident
Certified number of beds 44
Total number of residents 40
Perc of occupied beds 90
Sprinkler status Yes
Number of Facility Reported Incidents2
Number of Substantiated Complaints1
Number of Fines0
Total Amount of Fines$0
Total Number of Penalties0
Total Number of Penalties0
Ratings Summary: ATTIC ANGEL PLACE HEALTH CENTER
Overall rating 5
5
Nursing Home Staffing 5
5
Registered Nurses only 5
5
Health Inspections 4
4
Quality Measures 5
5
Nursing Home Staffing Info: ATTIC ANGEL PLACE HEALTH CENTER
National AverageWisconsin AverageATTIC ANGEL PLACE HEALTH CENTER
Overall staff rating NA NA 5
5
Registered Nurses only rating NANA 5
5
Total Number of Residents NA NA 40
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 4.16 hours 5.19 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.55 hours 1.78 hours
Registered Nurses Hours per Residents per Day 0.81 hours 1.0 hours 1.65 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.55 hours 0.14 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.61 hours 3.4 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.09 hours 0.19 hours
Health Survey: ATTIC ANGEL PLACE HEALTH CENTER
Heath Survey Summary on 2014-02-06
Total Number of Health Deficiencies 3
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Heath Survey Summary on 2012-12-05
Total Number of Health Deficiencies 3
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Heath Survey Summary on 2011-09-26
Total Number of Health Deficiencies 6
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Health Survey Details: ATTIC ANGEL PLACE HEALTH CENTER
Inspection Results: 02/06/2014
Corrected Deficiency Scope and Severity
03/05/2014 Ensure services provided by the nursing facility meet professional standards of quality. Isolated/Minimal harm or potential for actual harm
03/05/2014 Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%. Isolated/Minimal harm or potential for actual harm
03/05/2014 Have a program that investigates, controls and keeps infection from spreading. Isolated/Minimal harm or potential for actual harm
Inspection Results: 12/05/2012
Corrected Deficiency Scope and Severity
01/04/2013 Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Isolated/Minimal harm or potential for actual harm
01/04/2013 Ensure each resident receives an accurate assessment by a qualified health professional. Isolated/Minimal harm or potential for actual harm
01/04/2013 Store, cook, and serve food in a safe and clean way. Widespread /Minimal harm or potential for actual harm
Inspection Results: 09/26/2011
Corrected Deficiency Scope and Severity
10/25/2011 Ensure that residents are fully informed and understand their health status, care and treatments. Isolated/Minimal harm or potential for actual harm
10/25/2011 Give residents a notice of rights, rules, services and charges. Widespread/Potential for minimal harm
10/25/2011 Allow residents to self-administer drugs if determined safe. Isolated/Minimal harm or potential for actual harm
10/25/2011 Ensure each resident receives an accurate assessment by a qualified health professional. Isolated/Minimal harm or potential for actual harm
10/25/2011 Provide care by qualified persons according to each resident's written plan of care. Isolated/Minimal harm or potential for actual harm
10/25/2011 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Minimal harm or potential for actual harm

Fire Safety Survey: ATTIC ANGEL PLACE HEALTH CENTER
Fire Safety Survey Summary on 2014-02-05
Total Number of Fire SafetyDeficiencies 3
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2012-12-04
Total Number of Fire SafetyDeficiencies 6
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2011-09-21
Total Number of Fire SafetyDeficiencies 5
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey: ATTIC ANGEL PLACE HEALTH CENTER
Fire Safety Survey Results: 02/05/2014
Corrected Deficiency Severity
02/17/2014 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Pattern/Minimal harm or potential for actual harm
02/17/2014 Exits that are free from obstructions and can be used at all times. Isolated/Minimal harm or potential for actual harm
02/17/2014 Properly installed electrical wiring and equipment. Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Results: 12/04/2012
Corrected Deficiency Severity
12/05/2012 Back-up procedures in place for a faulty automatic sprinkler system. Widespread/Potential for minimal harm
12/05/2012 Portable fire extinguishers. Isolated/Minimal harm or potential for actual harm
12/05/2012 An approved back-up procedure for a faulty fire alarm system. Widespread/Potential for minimal harm
12/11/2012 Approved construction type or materials. Pattern/Minimal harm or potential for actual harm
12/05/2012 Properly installed electrical wiring and equipment. Pattern/Minimal harm or potential for actual harm
12/05/2012 Exits that are accessible at all times. Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Results: 09/21/2011
Corrected Deficiency Severity
10/25/2011 Corridor and hallway doors that block smoke. Pattern/Minimal harm or potential for actual harm
10/25/2011 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Isolated/Minimal harm or potential for actual harm
10/25/2011 A written emergency evacuation plan. Widespread/Potential for minimal harm
10/25/2011 Record of quarterly fire drills for each shift under varying conditions. Widespread /Minimal harm or potential for actual harm
10/25/2011 Automatic sprinkler systems that have been maintained in working order. Pattern/Minimal harm or potential for actual harm

Resident Complaints: ATTIC ANGEL PLACE HEALTH CENTER
Date Complaint Substantiated: 06/03/2013
CorrectedCategoryDeficiencySeverity
07/02/20131) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. D
07/02/2013Provide care by qualified persons according to each resident's written plan of care. D
07/02/2013Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. D
Date Complaint Substantiated: 10/09/2012
CorrectedCategoryDeficiencySeverity
1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. D
Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. D

Quality Measures: ATTIC ANGEL PLACE HEALTH CENTER
Quality Measures National Average Wisconsin Average ATTIC ANGEL PLACE HEALTH CENTER
Overall quality rating NA NA 5
5
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 14.4% 5.7%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 9.0% 11.4%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 4.3% 0.0%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 7.0% 18.9%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 43.7% %
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 3.8% 1.6%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 5.5% 10.8%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 5.8% 2.7%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 0.7% 0.0%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 3.4% 2.7%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 94.4% 100.0%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 98.2% 100.0%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 16.5% 26.7%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 21.1% 23.6%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 1.1% 0.0%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 88.6% 99.4%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 91.2% 97.0%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 1.5% 0.5%

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