Blue Valley Lutheran Care Home - Hebron Nursing Home
General Information
UPDATEFederal Provider Number
280000000000000000000000000000
Provider Name
BLUE VALLEY LUTHERAN CARE HOME
Provider Address
P O BOX 166, 755 SOUTH 3RD STREET
HEBRON, NE 68370
HEBRON, NE 68370
Provider Phone Number
4027683930
Provider SSA County
840
Provider County Name
Thayer
Ownership Type
Non profit - Corporation
Number of Certified Beds
64
Number of Residents in Certified Beds
49
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1991-11-22
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.02041
Reported LPN Staffing Hours per Resident per Day
0.72551
Reported RN Staffing Hours per Resident per Day
0.44082
Reported Licensed Staffing Hours per Resident per Day
1.16633
Reported Total Nurse Staffing Hours per Resident per Day
4.18674
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.66434
Expected LPN Staffing Hours per Resident per Day
0.65698
Expected RN Staffing Hours per Resident per Day
0.79988
Expected Total Nurse Staffing Hours per Resident per Day
4.12119
Adjusted CNA Staffing Hours per Resident per Day
2.78162
Adjusted LPN Staffing Hours per Resident per Day
0.91658
Adjusted RN Staffing Hours per Resident per Day
0.41179
Adjusted Total Nurse Staffing Hours per Resident per Day
4.09501
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-04-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-04-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-03-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
22.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Blue Valley Lutheran Nursing Home
P O Box 166, 220 Park Avenue |
HEBRON NE 68370 | 0 mile away
Parkview Haven Nursing Home
P O Box 667, 1203 4th Street |
DESHLER NE 68340 | 7.1 miles away
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