Golden Livingcenter - Clark - Clark Nursing Home
General Information
UPDATEFederal Provider Number
435058
Provider Name
GOLDEN LIVINGCENTER - CLARK
Provider Address
201 8TH AVENUE NW
CLARK, SD 57225
CLARK, SD 57225
Provider Phone Number
6055323431
Provider SSA County
120
Provider County Name
Clark
Ownership Type
For profit - Corporation
Number of Certified Beds
38
Number of Residents in Certified Beds
35
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GGNSC CLARK LLC
Date First Approved to Provide Medicare and Medicaid services
1991-05-01
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
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.73714
Reported LPN Staffing Hours per Resident per Day
0.41429
Reported RN Staffing Hours per Resident per Day
1.05286
Reported Licensed Staffing Hours per Resident per Day
1.46714
Reported Total Nurse Staffing Hours per Resident per Day
3.20429
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06143
Expected CNA Staffing Hours per Resident per Day
2.40614
Expected LPN Staffing Hours per Resident per Day
0.62081
Expected RN Staffing Hours per Resident per Day
0.98432
Expected Total Nurse Staffing Hours per Resident per Day
4.01127
Adjusted CNA Staffing Hours per Resident per Day
1.77147
Adjusted LPN Staffing Hours per Resident per Day
0.55389
Adjusted RN Staffing Hours per Resident per Day
0.79923
Adjusted Total Nurse Staffing Hours per Resident per Day
3.21997
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-03-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2014-02-12
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-11-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
19.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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