Birchwood Manor - North Bend Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
285247
Provider Name
BIRCHWOOD MANOR
Provider Address
1120 WALNUT ST
NORTH BEND, NE 68649
NORTH BEND, NE 68649
Provider Phone Number
(402) 652-3242
Provider SSA County
260
Provider County Name
Dodge
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
53
Number of Residents in Certified Beds
51
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CELEBRATE LIFE, INC.
Date First Approved to Provide Medicare and Medicaid services
2002-05-01
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
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
2
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
2.15490
Reported LPN Staffing Hours per Resident per Day
0.32647
Reported RN Staffing Hours per Resident per Day
0.61765
Reported Licensed Staffing Hours per Resident per Day
0.94412
Reported Total Nurse Staffing Hours per Resident per Day
3.09902
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01078
Expected CNA Staffing Hours per Resident per Day
2.40926
Expected LPN Staffing Hours per Resident per Day
0.65459
Expected RN Staffing Hours per Resident per Day
1.06246
Expected Total Nurse Staffing Hours per Resident per Day
4.12632
Adjusted CNA Staffing Hours per Resident per Day
2.19465
Adjusted LPN Staffing Hours per Resident per Day
0.41395
Adjusted RN Staffing Hours per Resident per Day
0.43438
Adjusted Total Nurse Staffing Hours per Resident per Day
3.02736
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
56
Cycle 1 Standard Survey Health Date
2014-12-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-10-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-10-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
47.33300
Number of Facility Reported Incidents
5
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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