Maple Manor Care Center - Langdon Nursing Home
General Information
UPDATEFederal Provider Number
355050
Provider Name
MAPLE MANOR CARE CENTER
Provider Address
1116 9TH AVE
LANGDON, ND 58249
LANGDON, ND 58249
Provider Phone Number
7012562987
Provider SSA County
90
Provider County Name
Cavalier
Ownership Type
Non profit - Other
Number of Certified Beds
63
Number of Residents in Certified Beds
52
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MAPLE MANOR CARE CENTER
Date First Approved to Provide Medicare and Medicaid services
1978-06-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
3.54231
Reported LPN Staffing Hours per Resident per Day
0.62115
Reported RN Staffing Hours per Resident per Day
0.68942
Reported Licensed Staffing Hours per Resident per Day
1.31058
Reported Total Nurse Staffing Hours per Resident per Day
4.85288
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.43925
Expected LPN Staffing Hours per Resident per Day
0.52829
Expected RN Staffing Hours per Resident per Day
0.74667
Expected Total Nurse Staffing Hours per Resident per Day
3.71420
Adjusted CNA Staffing Hours per Resident per Day
3.56330
Adjusted LPN Staffing Hours per Resident per Day
0.97590
Adjusted RN Staffing Hours per Resident per Day
0.68991
Adjusted Total Nurse Staffing Hours per Resident per Day
5.26667
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-05-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
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
2013-04-04
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-03-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
10.66700
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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