Five Counties Nursing Home - Lemmon Nursing Home
General Information
UPDATEFederal Provider Number
435090
Provider Name
FIVE COUNTIES NURSING HOME
Provider Address
405 6TH AVENUE WEST
LEMMON, SD 57638
LEMMON, SD 57638
Provider Phone Number
6053743871
Provider SSA County
520
Provider County Name
Perkins
Ownership Type
Non profit - Corporation
Number of Certified Beds
45
Number of Residents in Certified Beds
42
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LEMMON AREA MEDICAL ASSOCIATION
Date First Approved to Provide Medicare and Medicaid services
1995-09-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
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
1.72500
Reported LPN Staffing Hours per Resident per Day
0.80595
Reported RN Staffing Hours per Resident per Day
0.47381
Reported Licensed Staffing Hours per Resident per Day
1.27976
Reported Total Nurse Staffing Hours per Resident per Day
3.00476
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.11096
Expected LPN Staffing Hours per Resident per Day
0.58396
Expected RN Staffing Hours per Resident per Day
0.83455
Expected Total Nurse Staffing Hours per Resident per Day
3.52947
Adjusted CNA Staffing Hours per Resident per Day
2.00507
Adjusted LPN Staffing Hours per Resident per Day
1.14553
Adjusted RN Staffing Hours per Resident per Day
0.42422
Adjusted Total Nurse Staffing Hours per Resident per Day
3.43165
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
9
Cycle 1 Health Deficiency Score
1356
Cycle 1 Standard Survey Health Date
2014-07-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
1356
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-06-12
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
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-04-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
696.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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