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Elim Care Center - Fargo Nursing Home

General Information

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Federal Provider Number
355085
Provider Name
ELIM CARE CENTER
Provider Address
3534 UNIVERSITY DR S
FARGO, ND 58104
Provider Phone Number
(701) 271-1800
Provider SSA County
80
Provider County Name
Cass
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
136
Number of Residents in Certified Beds
132
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ELIM HOMES, INC.
Date First Approved to Provide Medicare and Medicaid services
1978-12-01
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
4
QM Rating Footnote
Staffing Rating
4
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
3.01932
Reported LPN Staffing Hours per Resident per Day
0.62652
Reported RN Staffing Hours per Resident per Day
0.65720
Reported Licensed Staffing Hours per Resident per Day
1.28371
Reported Total Nurse Staffing Hours per Resident per Day
4.30304
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04394
Expected CNA Staffing Hours per Resident per Day
2.46776
Expected LPN Staffing Hours per Resident per Day
0.65308
Expected RN Staffing Hours per Resident per Day
0.96831
Expected Total Nurse Staffing Hours per Resident per Day
4.08914
Adjusted CNA Staffing Hours per Resident per Day
3.00212
Adjusted LPN Staffing Hours per Resident per Day
0.79625
Adjusted RN Staffing Hours per Resident per Day
0.50713
Adjusted Total Nurse Staffing Hours per Resident per Day
4.24175
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
28
Cycle 1 Standard Survey Health Date
2014-08-07
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
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-08-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-08-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
27.33300
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
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