Jennie M Melham Medical Center - Broken Bow Nursing Home

General Information

UPDATE
Federal Provider Number
28A056
Provider Name
JENNIE M MELHAM MEDICAL CENTER
Provider Address
P O BOX 250, 145 MEMORIAL DRIVE
BROKEN BOW, NE 68822
Provider Phone Number
3088724100
Provider SSA County
200
Provider County Name
Custer
Ownership Type
Non profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
29
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
1989-08-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
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
2.92414
Reported LPN Staffing Hours per Resident per Day
1.29310
Reported RN Staffing Hours per Resident per Day
1.12586
Reported Licensed Staffing Hours per Resident per Day
2.41897
Reported Total Nurse Staffing Hours per Resident per Day
5.34310
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00172
Expected CNA Staffing Hours per Resident per Day
2.53495
Expected LPN Staffing Hours per Resident per Day
0.65756
Expected RN Staffing Hours per Resident per Day
0.89645
Expected Total Nurse Staffing Hours per Resident per Day
4.08896
Adjusted CNA Staffing Hours per Resident per Day
2.83041
Adjusted LPN Staffing Hours per Resident per Day
1.63221
Adjusted RN Staffing Hours per Resident per Day
0.93842
Adjusted Total Nurse Staffing Hours per Resident per Day
5.26724
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-09-03
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
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-06-10
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
14
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
171
Cycle 3 Standard Health Survey Date
2012-03-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
171
Total Weighted Health Survey Score
35.83300
Number of Facility Reported Incidents
5
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

Nursiong Homes Nearby

Golden Livingcenter - Broken Bow

224 East South E Street | BROKEN BOW NE 68822 | 0.5 mile away

Callaway Good Life Center, Inc

Po Box 250, 600 West Kimball Street | CALLAWAY NE 68825 | 17 miles away

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