North Dakota Nursing Homes >> Fargo Nursing Homes >> Bethany On 42nd

Bethany On 42nd - Fargo Nursing Home

General Information

UPDATE
Federal Provider Number
355123
Provider Name
BETHANY ON 42ND
Provider Address
4255 30TH AVE S
FARGO, ND 58104
Provider Phone Number
7014788900
Provider SSA County
80
Provider County Name
Cass
Ownership Type
Non profit - Corporation
Number of Certified Beds
116
Number of Residents in Certified Beds
115
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BETHANY ON 42ND
Date First Approved to Provide Medicare and Medicaid services
2010-01-20
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
3
Health Inspection Rating Footnote
QM Rating
5
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
3.48174
Reported LPN Staffing Hours per Resident per Day
1.06609
Reported RN Staffing Hours per Resident per Day
0.97348
Reported Licensed Staffing Hours per Resident per Day
2.03957
Reported Total Nurse Staffing Hours per Resident per Day
5.52131
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06261
Expected CNA Staffing Hours per Resident per Day
2.47303
Expected LPN Staffing Hours per Resident per Day
0.57954
Expected RN Staffing Hours per Resident per Day
0.92817
Expected Total Nurse Staffing Hours per Resident per Day
3.98073
Adjusted CNA Staffing Hours per Resident per Day
3.45453
Adjusted LPN Staffing Hours per Resident per Day
1.52683
Adjusted RN Staffing Hours per Resident per Day
0.78368
Adjusted Total Nurse Staffing Hours per Resident per Day
5.59089
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
9
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-12-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-02-06
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-11-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
26.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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