Idaho State Veterans Home - Pocatello - Pocatello Nursing Home

General Information

UPDATE
Federal Provider Number
135132
Provider Name
IDAHO STATE VETERANS HOME - POCATELLO
Provider Address
1957 ALVIN RICKEN DRIVE
POCATELLO, ID 83201
Provider Phone Number
(208) 236-6340
Provider SSA County
20
Provider County Name
Bannock
Provider Website
Provider Description
Ownership Type
Government - State
Number of Certified Beds
66
Number of Residents in Certified Beds
46
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DIVISION OF VETERANS SERVICES
Date First Approved to Provide Medicare and Medicaid services
2007-11-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
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
1
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
2.79239
Reported LPN Staffing Hours per Resident per Day
1.14022
Reported RN Staffing Hours per Resident per Day
1.15761
Reported Licensed Staffing Hours per Resident per Day
2.29783
Reported Total Nurse Staffing Hours per Resident per Day
5.09022
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00978
Expected CNA Staffing Hours per Resident per Day
2.27154
Expected LPN Staffing Hours per Resident per Day
0.66266
Expected RN Staffing Hours per Resident per Day
1.06352
Expected Total Nurse Staffing Hours per Resident per Day
3.99773
Adjusted CNA Staffing Hours per Resident per Day
3.01631
Adjusted LPN Staffing Hours per Resident per Day
1.42815
Adjusted RN Staffing Hours per Resident per Day
0.81330
Adjusted Total Nurse Staffing Hours per Resident per Day
5.13246
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
40
Cycle 1 Standard Survey Health Date
2014-04-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-03-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2011-12-02
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
30
Cycle 3 Total Health Score
90
Total Weighted Health Survey Score
51.00000
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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