Griggs County Care Center - Cooperstown Nursing Home
General Information
UPDATEFederal Provider Number
355039
Provider Name
GRIGGS COUNTY CARE CENTER
Provider Address
1200 ROBERTS AVE NE
COOPERSTOWN, ND 58425
COOPERSTOWN, ND 58425
Provider Phone Number
7017972221
Provider SSA County
190
Provider County Name
Griggs
Ownership Type
Non profit - Corporation
Number of Certified Beds
48
Number of Residents in Certified Beds
47
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GRIGGS COUNTY NURSING HOME
Date First Approved to Provide Medicare and Medicaid services
1978-04-01
Continuing Care Retirement Community
N
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
4
Overall Rating Footnote
Health Inspection Rating
4
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
3.02340
Reported LPN Staffing Hours per Resident per Day
0.87021
Reported RN Staffing Hours per Resident per Day
0.69362
Reported Licensed Staffing Hours per Resident per Day
1.56383
Reported Total Nurse Staffing Hours per Resident per Day
4.58723
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.37506
Expected LPN Staffing Hours per Resident per Day
0.73174
Expected RN Staffing Hours per Resident per Day
0.95124
Expected Total Nurse Staffing Hours per Resident per Day
4.05804
Adjusted CNA Staffing Hours per Resident per Day
3.12351
Adjusted LPN Staffing Hours per Resident per Day
0.98707
Adjusted RN Staffing Hours per Resident per Day
0.54484
Adjusted Total Nurse Staffing Hours per Resident per Day
4.55655
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-05-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
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
12
Cycle 2 Standard Health Survey Date
2013-06-20
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-04-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
11.33300
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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