Golden Ours Convalescent Home - Grant Nursing Home
General Information
UPDATEFederal Provider Number
280000000000000000000000000000
Provider Name
GOLDEN OURS CONVALESCENT HOME
Provider Address
902 CENTRAL AVENUE
GRANT, NE 69140
GRANT, NE 69140
Provider Phone Number
3083527200
Provider SSA County
670
Provider County Name
Perkins
Ownership Type
Government - Hospital district
Number of Certified Beds
50
Number of Residents in Certified Beds
41
Provider Type
Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1974-03-31
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
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
4
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
2.50000
Reported LPN Staffing Hours per Resident per Day
0.81098
Reported RN Staffing Hours per Resident per Day
0.83049
Reported Licensed Staffing Hours per Resident per Day
1.64146
Reported Total Nurse Staffing Hours per Resident per Day
4.14147
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00854
Expected CNA Staffing Hours per Resident per Day
2.58294
Expected LPN Staffing Hours per Resident per Day
0.52926
Expected RN Staffing Hours per Resident per Day
0.73777
Expected Total Nurse Staffing Hours per Resident per Day
3.84997
Adjusted CNA Staffing Hours per Resident per Day
2.37491
Adjusted LPN Staffing Hours per Resident per Day
1.27180
Adjusted RN Staffing Hours per Resident per Day
0.84110
Adjusted Total Nurse Staffing Hours per Resident per Day
4.33610
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-06-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-03-28
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
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-03-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
54.00000
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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