Faith Lutheran Home - Wolf Point Nursing Home
General Information
UPDATEFederal Provider Number
275073
Provider Name
FAITH LUTHERAN HOME
Provider Address
1000 6TH AVE N
WOLF POINT, MT 59201
WOLF POINT, MT 59201
Provider Phone Number
4066531400
Provider SSA County
420
Provider County Name
Roosevelt
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
54
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NORTHEAST MONTANA HEALTH SERVICES, INC.
Date First Approved to Provide Medicare and Medicaid services
1977-09-01
Continuing Care Retirement Community
Y
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
5
Health Inspection Rating Footnote
QM Rating
5
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
2.74907
Reported LPN Staffing Hours per Resident per Day
0.26481
Reported RN Staffing Hours per Resident per Day
0.66296
Reported Licensed Staffing Hours per Resident per Day
0.92778
Reported Total Nurse Staffing Hours per Resident per Day
3.67684
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.14867
Expected LPN Staffing Hours per Resident per Day
0.62695
Expected RN Staffing Hours per Resident per Day
0.76685
Expected Total Nurse Staffing Hours per Resident per Day
3.54248
Adjusted CNA Staffing Hours per Resident per Day
3.13933
Adjusted LPN Staffing Hours per Resident per Day
0.35057
Adjusted RN Staffing Hours per Resident per Day
0.64597
Adjusted Total Nurse Staffing Hours per Resident per Day
4.18379
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
16
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
16
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
24
Cycle 2 Standard Health Survey Date
2014-01-30
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-12-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
20.66700
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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