Prairie Manor Nursing Home - Pine Prairie Nursing Home
General Information
UPDATEFederal Provider Number
195577
Provider Name
PRAIRIE MANOR NURSING HOME
Provider Address
1050 EDWIN ELLIOTT DRIVE
PINE PRAIRIE, LA 70576
PINE PRAIRIE, LA 70576
Provider Phone Number
3375992031
Provider SSA County
190
Provider County Name
Evangeline
Ownership Type
Non profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PRAIRIE MANOR, INC.
Date First Approved to Provide Medicare and Medicaid services
2003-04-11
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
5
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.98488
Reported LPN Staffing Hours per Resident per Day
1.16744
Reported RN Staffing Hours per Resident per Day
0.57616
Reported Licensed Staffing Hours per Resident per Day
1.74360
Reported Total Nurse Staffing Hours per Resident per Day
4.72848
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03837
Expected CNA Staffing Hours per Resident per Day
2.46501
Expected LPN Staffing Hours per Resident per Day
0.69969
Expected RN Staffing Hours per Resident per Day
1.14997
Expected Total Nurse Staffing Hours per Resident per Day
4.31468
Adjusted CNA Staffing Hours per Resident per Day
2.97118
Adjusted LPN Staffing Hours per Resident per Day
1.38486
Adjusted RN Staffing Hours per Resident per Day
0.37436
Adjusted Total Nurse Staffing Hours per Resident per Day
4.41749
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-07-17
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
12
Cycle 2 Standard Health Survey Date
2013-06-06
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
2012-07-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
10.00000
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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