Bell Mountain Village & Care Center - Bellevue Nursing Home
General Information
UPDATEFederal Provider Number
135069
Provider Name
BELL MOUNTAIN VILLAGE & CARE CENTER
Provider Address
620 NORTH SIXTH STREET
BELLEVUE, ID 83313
BELLEVUE, ID 83313
Provider Phone Number
2087887180
Provider SSA County
60
Provider County Name
Blaine
Ownership Type
For profit - Corporation
Number of Certified Beds
25
Number of Residents in Certified Beds
22
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SAFE HAVEN HEALTH CARE LLC
Date First Approved to Provide Medicare and Medicaid services
1982-05-07
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
5
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
3.26818
Reported LPN Staffing Hours per Resident per Day
0.67727
Reported RN Staffing Hours per Resident per Day
1.21818
Reported Licensed Staffing Hours per Resident per Day
1.89545
Reported Total Nurse Staffing Hours per Resident per Day
5.16363
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01364
Expected CNA Staffing Hours per Resident per Day
2.60462
Expected LPN Staffing Hours per Resident per Day
0.68143
Expected RN Staffing Hours per Resident per Day
0.97284
Expected Total Nurse Staffing Hours per Resident per Day
4.25889
Adjusted CNA Staffing Hours per Resident per Day
3.07882
Adjusted LPN Staffing Hours per Resident per Day
0.82493
Adjusted RN Staffing Hours per Resident per Day
0.93563
Adjusted Total Nurse Staffing Hours per Resident per Day
4.88720
Cycle 1 Total Number of Health Deficiencies
23
Cycle 1 Number of Standard Health Deficiencies
17
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
184
Cycle 1 Standard Survey Health Date
2015-02-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
184
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2013-12-06
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
14
Cycle 3 Number of Standard Health Deficiencies
14
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2012-10-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
130.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
14
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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