Country Life Care Center - Riverton Nursing Home

General Information

UPDATE
Federal Provider Number
465179
Provider Name
COUNTRY LIFE CARE CENTER
Provider Address
13747 SOUTH REDWOOD ROAD
RIVERTON, UT 84065
Provider Phone Number
8014910682
Provider SSA County
170
Provider County Name
Salt Lake
Ownership Type
For profit - Corporation
Number of Certified Beds
36
Number of Residents in Certified Beds
34
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTRY LIFE CARE CENTERS
Date First Approved to Provide Medicare and Medicaid services
2013-03-25
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
3.95735
Reported LPN Staffing Hours per Resident per Day
0.45441
Reported RN Staffing Hours per Resident per Day
3.66324
Reported Licensed Staffing Hours per Resident per Day
4.11765
Reported Total Nurse Staffing Hours per Resident per Day
8.07500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.33088
Expected CNA Staffing Hours per Resident per Day
2.66054
Expected LPN Staffing Hours per Resident per Day
1.09227
Expected RN Staffing Hours per Resident per Day
1.81763
Expected Total Nurse Staffing Hours per Resident per Day
5.57045
Adjusted CNA Staffing Hours per Resident per Day
3.64969
Adjusted LPN Staffing Hours per Resident per Day
0.34530
Adjusted RN Staffing Hours per Resident per Day
1.50590
Adjusted Total Nurse Staffing Hours per Resident per Day
5.84325
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-12-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-02-26
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-03-21
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
12.00000
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

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