Bethel Lutheran Nursing & Rehabilitation Center - Williston Nursing Home
General Information
UPDATEFederal Provider Number
355070
Provider Name
BETHEL LUTHERAN NURSING & REHABILITATION CENTER
Provider Address
1515 2ND AVE WEST
WILLISTON, ND 58801
WILLISTON, ND 58801
Provider Phone Number
7015726766
Provider SSA County
520
Provider County Name
Williams
Ownership Type
Non profit - Church related
Number of Certified Beds
168
Number of Residents in Certified Beds
156
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BETHEL LUTHERAN NURSING & REHABILITATION CENTER
Date First Approved to Provide Medicare and Medicaid services
1978-08-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.38750
Reported LPN Staffing Hours per Resident per Day
0.77532
Reported RN Staffing Hours per Resident per Day
0.75865
Reported Licensed Staffing Hours per Resident per Day
1.53397
Reported Total Nurse Staffing Hours per Resident per Day
4.92147
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07372
Expected CNA Staffing Hours per Resident per Day
2.41188
Expected LPN Staffing Hours per Resident per Day
0.60207
Expected RN Staffing Hours per Resident per Day
0.83423
Expected Total Nurse Staffing Hours per Resident per Day
3.84818
Adjusted CNA Staffing Hours per Resident per Day
3.44624
Adjusted LPN Staffing Hours per Resident per Day
1.06884
Adjusted RN Staffing Hours per Resident per Day
0.67950
Adjusted Total Nurse Staffing Hours per Resident per Day
5.15515
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-08-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
13
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-08-29
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
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-08-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
59.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
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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