Elm Crest Manor - New Salem Nursing Home

General Information

UPDATE
Federal Provider Number
355110
Provider Name
ELM CREST MANOR
Provider Address
100 ELM AVE
NEW SALEM, ND 58563
Provider Phone Number
7018437526
Provider SSA County
290
Provider County Name
Morton
Ownership Type
Non profit - Church related
Number of Certified Beds
68
Number of Residents in Certified Beds
68
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ELM CREST MANOR
Date First Approved to Provide Medicare and Medicaid services
1991-11-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
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
3.99485
Reported LPN Staffing Hours per Resident per Day
0.57647
Reported RN Staffing Hours per Resident per Day
0.75000
Reported Licensed Staffing Hours per Resident per Day
1.32647
Reported Total Nurse Staffing Hours per Resident per Day
5.32132
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09118
Expected CNA Staffing Hours per Resident per Day
2.42697
Expected LPN Staffing Hours per Resident per Day
0.58730
Expected RN Staffing Hours per Resident per Day
0.77294
Expected Total Nurse Staffing Hours per Resident per Day
3.78722
Adjusted CNA Staffing Hours per Resident per Day
4.03885
Adjusted LPN Staffing Hours per Resident per Day
0.81469
Adjusted RN Staffing Hours per Resident per Day
0.72502
Adjusted Total Nurse Staffing Hours per Resident per Day
5.66371
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-07-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
141
Cycle 2 Standard Health Survey Date
2013-07-03
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
7
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-07-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
67.66700
Number of Facility Reported Incidents
0
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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