Idaho Nursing Homes >> Soda Springs Nursing Homes >> Caribou Memorial Living Ctr

Caribou Memorial Living Ctr - Soda Springs Nursing Home

General Information

UPDATE
Federal Provider Number
135060
Provider Name
CARIBOU MEMORIAL LIVING CTR
Provider Address
300 SOUTH THIRD WEST
SODA SPRINGS, ID 83276
Provider Phone Number
2085473341
Provider SSA County
140
Provider County Name
Caribou
Ownership Type
Government - City/county
Number of Certified Beds
30
Number of Residents in Certified Beds
25
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
CARIBOU MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1975-08-21
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.85000
Reported LPN Staffing Hours per Resident per Day
1.33000
Reported RN Staffing Hours per Resident per Day
0.93600
Reported Licensed Staffing Hours per Resident per Day
2.26600
Reported Total Nurse Staffing Hours per Resident per Day
6.11600
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00200
Expected CNA Staffing Hours per Resident per Day
2.57127
Expected LPN Staffing Hours per Resident per Day
0.75618
Expected RN Staffing Hours per Resident per Day
1.02435
Expected Total Nurse Staffing Hours per Resident per Day
4.35179
Adjusted CNA Staffing Hours per Resident per Day
3.67397
Adjusted LPN Staffing Hours per Resident per Day
1.45985
Adjusted RN Staffing Hours per Resident per Day
0.68276
Adjusted Total Nurse Staffing Hours per Resident per Day
5.66503
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2015-02-27
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-12-06
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
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2012-10-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
78.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
2
Total Amount of Fines in Dollars
8255
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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