Clark Fork Valley Nursing Home - Plains Nursing Home
General Information
UPDATEFederal Provider Number
275107
Provider Name
CLARK FORK VALLEY NURSING HOME
Provider Address
10 KRUGER RD
PLAINS, MT 59859
PLAINS, MT 59859
Provider Phone Number
4068264800
Provider SSA County
440
Provider County Name
Sanders
Ownership Type
Non profit - Corporation
Number of Certified Beds
28
Number of Residents in Certified Beds
25
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
PLAINS HOSPITAL CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1985-01-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
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
2.82800
Reported LPN Staffing Hours per Resident per Day
0.20600
Reported RN Staffing Hours per Resident per Day
1.59000
Reported Licensed Staffing Hours per Resident per Day
1.79600
Reported Total Nurse Staffing Hours per Resident per Day
4.62400
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.33480
Expected LPN Staffing Hours per Resident per Day
0.57673
Expected RN Staffing Hours per Resident per Day
0.83900
Expected Total Nurse Staffing Hours per Resident per Day
3.75053
Adjusted CNA Staffing Hours per Resident per Day
2.97202
Adjusted LPN Staffing Hours per Resident per Day
0.29646
Adjusted RN Staffing Hours per Resident per Day
1.41603
Adjusted Total Nurse Staffing Hours per Resident per Day
4.96966
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
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
28
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-11-21
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
72
Cycle 3 Standard Health Survey Date
2012-10-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
31.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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
Nursiong Homes Nearby
Hot Springs Health & Rehabilitation Center
600 1st Ave N |
HOT SPRINGS MT 59845 | 14 miles away
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