Crowell Memorial Home - Blair Nursing Home
General Information
UPDATEFederal Provider Number
285210
Provider Name
CROWELL MEMORIAL HOME
Provider Address
245 SOUTH 22ND STREET
BLAIR, NE 68008
BLAIR, NE 68008
Provider Phone Number
(402) 426-2177
Provider SSA County
880
Provider County Name
Washington
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
88
Number of Residents in Certified Beds
67
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CROWELL MEMORIAL HOME
Date First Approved to Provide Medicare and Medicaid services
1997-07-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
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
2.87164
Reported LPN Staffing Hours per Resident per Day
1.10970
Reported RN Staffing Hours per Resident per Day
0.63657
Reported Licensed Staffing Hours per Resident per Day
1.74627
Reported Total Nurse Staffing Hours per Resident per Day
4.61791
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05448
Expected CNA Staffing Hours per Resident per Day
2.30423
Expected LPN Staffing Hours per Resident per Day
0.55229
Expected RN Staffing Hours per Resident per Day
0.91734
Expected Total Nurse Staffing Hours per Resident per Day
3.77386
Adjusted CNA Staffing Hours per Resident per Day
3.05792
Adjusted LPN Staffing Hours per Resident per Day
1.66769
Adjusted RN Staffing Hours per Resident per Day
0.51851
Adjusted Total Nurse Staffing Hours per Resident per Day
4.93244
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-09-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-05-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-02-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
32.66700
Number of Facility Reported Incidents
1
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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