Bentonville Manor Nursing Home - Bentonville Nursing Home
General Information
UPDATEFederal Provider Number
45361
Provider Name
BENTONVILLE MANOR NURSING HOME
Provider Address
224 SOUTH MAIN STREET
BENTONVILLE, AR 72712
BENTONVILLE, AR 72712
Provider Phone Number
4792733373
Provider SSA County
30
Provider County Name
Benton
Ownership Type
For profit - Corporation
Number of Certified Beds
95
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BENTON NURSING, LLC
Date First Approved to Provide Medicare and Medicaid services
2001-01-03
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
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.14923
Reported LPN Staffing Hours per Resident per Day
0.89923
Reported RN Staffing Hours per Resident per Day
0.41308
Reported Licensed Staffing Hours per Resident per Day
1.31231
Reported Total Nurse Staffing Hours per Resident per Day
3.46154
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01000
Expected CNA Staffing Hours per Resident per Day
2.27674
Expected LPN Staffing Hours per Resident per Day
0.55233
Expected RN Staffing Hours per Resident per Day
0.75633
Expected Total Nurse Staffing Hours per Resident per Day
3.58539
Adjusted CNA Staffing Hours per Resident per Day
2.31628
Adjusted LPN Staffing Hours per Resident per Day
1.35130
Adjusted RN Staffing Hours per Resident per Day
0.40810
Adjusted Total Nurse Staffing Hours per Resident per Day
3.89166
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
395
Cycle 1 Standard Survey Health Date
2015-01-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
395
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
9
Cycle 2 Health Deficiency Score
156
Cycle 2 Standard Health Survey Date
2013-12-19
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
15
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
108
Cycle 3 Standard Health Survey Date
2012-11-16
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
54
Cycle 3 Total Health Score
162
Total Weighted Health Survey Score
276.50000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
14
Number of Fines
1
Total Amount of Fines in Dollars
60000
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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