Midwest Covenant Home - Stromsburg Nursing Home
General Information
UPDATEFederal Provider Number
285062
Provider Name
MIDWEST COVENANT HOME
Provider Address
P O BOX 367, 615 EAST 9TH STREET
STROMSBURG, NE 68666
STROMSBURG, NE 68666
Provider Phone Number
4027642711
Provider SSA County
710
Provider County Name
Polk
Ownership Type
Non profit - Church related
Number of Certified Beds
58
Number of Residents in Certified Beds
47
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MIDWEST COVENANT HOME INC
Date First Approved to Provide Medicare and Medicaid services
1983-09-20
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
2.20851
Reported LPN Staffing Hours per Resident per Day
0.97340
Reported RN Staffing Hours per Resident per Day
0.67340
Reported Licensed Staffing Hours per Resident per Day
1.64681
Reported Total Nurse Staffing Hours per Resident per Day
3.85531
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02766
Expected CNA Staffing Hours per Resident per Day
2.67059
Expected LPN Staffing Hours per Resident per Day
0.56357
Expected RN Staffing Hours per Resident per Day
0.77173
Expected Total Nurse Staffing Hours per Resident per Day
4.00589
Adjusted CNA Staffing Hours per Resident per Day
2.02915
Adjusted LPN Staffing Hours per Resident per Day
1.43359
Adjusted RN Staffing Hours per Resident per Day
0.65199
Adjusted Total Nurse Staffing Hours per Resident per Day
3.87938
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
12
Cycle 1 Standard Survey Health Date
2014-07-28
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
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-04-30
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
5
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-01-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
17.33300
Number of Facility Reported Incidents
6
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
Nursiong Homes Nearby
Good Samaritan Society - Osceola
600 Center Drive |
OSCEOLA NE 68651 | 4.8 miles away
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