Little Cottonwood Rehabilitation And Nursing - Salt Lake City Nursing Home
General Information
UPDATEFederal Provider Number
46A066
Provider Name
LITTLE COTTONWOOD REHABILITATION AND NURSING
Provider Address
3094 SOUTH STATE STREET
SALT LAKE CITY, UT 84115
SALT LAKE CITY, UT 84115
Provider Phone Number
(801) 636-1661
Provider SSA County
170
Provider County Name
Salt Lake
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
37
Number of Residents in Certified Beds
35
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1992-02-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.60714
Reported LPN Staffing Hours per Resident per Day
0.37143
Reported RN Staffing Hours per Resident per Day
0.60429
Reported Licensed Staffing Hours per Resident per Day
0.97571
Reported Total Nurse Staffing Hours per Resident per Day
2.58286
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.25990
Expected LPN Staffing Hours per Resident per Day
0.59521
Expected RN Staffing Hours per Resident per Day
1.27607
Expected Total Nurse Staffing Hours per Resident per Day
4.13119
Adjusted CNA Staffing Hours per Resident per Day
1.74496
Adjusted LPN Staffing Hours per Resident per Day
0.51794
Adjusted RN Staffing Hours per Resident per Day
0.35384
Adjusted Total Nurse Staffing Hours per Resident per Day
2.52016
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-04-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-05-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
6
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2011-08-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
49.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
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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