Arbor Manor - Fremont Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
285103
Provider Name
ARBOR MANOR
Provider Address
2550 NORTH NYE AVENUE
FREMONT, NE 68025
FREMONT, NE 68025
Provider Phone Number
(402) 727-1710
Provider SSA County
260
Provider County Name
Dodge
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
147
Number of Residents in Certified Beds
103
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SSC FREMONT OPERATING COMPANY LLC
Date First Approved to Provide Medicare and Medicaid services
1991-01-07
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
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.14757
Reported LPN Staffing Hours per Resident per Day
0.59612
Reported RN Staffing Hours per Resident per Day
0.34029
Reported Licensed Staffing Hours per Resident per Day
0.93641
Reported Total Nurse Staffing Hours per Resident per Day
3.08398
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.46768
Expected LPN Staffing Hours per Resident per Day
0.63358
Expected RN Staffing Hours per Resident per Day
1.05573
Expected Total Nurse Staffing Hours per Resident per Day
4.15699
Adjusted CNA Staffing Hours per Resident per Day
2.13540
Adjusted LPN Staffing Hours per Resident per Day
0.78093
Adjusted RN Staffing Hours per Resident per Day
0.24084
Adjusted Total Nurse Staffing Hours per Resident per Day
2.99044
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-10-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-07-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
92
Cycle 3 Standard Health Survey Date
2012-05-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
92
Total Weighted Health Survey Score
43.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
3
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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