Douglas Care Center Llc - Douglas Nursing Home
General Information
UPDATEFederal Provider Number
535040
Provider Name
DOUGLAS CARE CENTER LLC
Provider Address
1108 BIRCH STREET
DOUGLAS, WY 82633
DOUGLAS, WY 82633
Provider Phone Number
3073583397
Provider SSA County
40
Provider County Name
Converse
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
58
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DOUGLAS CARE CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
1990-01-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
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
2.02069
Reported LPN Staffing Hours per Resident per Day
0.50603
Reported RN Staffing Hours per Resident per Day
0.70086
Reported Licensed Staffing Hours per Resident per Day
1.20690
Reported Total Nurse Staffing Hours per Resident per Day
3.22758
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00603
Expected CNA Staffing Hours per Resident per Day
2.01043
Expected LPN Staffing Hours per Resident per Day
0.54336
Expected RN Staffing Hours per Resident per Day
0.78215
Expected Total Nurse Staffing Hours per Resident per Day
3.33595
Adjusted CNA Staffing Hours per Resident per Day
2.46622
Adjusted LPN Staffing Hours per Resident per Day
0.77297
Adjusted RN Staffing Hours per Resident per Day
0.66954
Adjusted Total Nurse Staffing Hours per Resident per Day
3.89996
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-08-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-08-15
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
25
Cycle 3 Number of Standard Health Deficiencies
23
Cycle 3 Number of Complaint Health Deficiencies
7
Cycle 3 Health Deficiency Score
223
Cycle 3 Standard Health Survey Date
2012-07-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
223
Total Weighted Health Survey Score
72.50000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
9
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
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