Mid-nebraska Lutheran Home - Newman Grove Nursing Home

General Information

UPDATE
Federal Provider Number
285213
Provider Name
MID-NEBRASKA LUTHERAN HOME
Provider Address
109 NORTH 2ND STREET
NEWMAN GROVE, NE 68758
Provider Phone Number
4024476203
Provider SSA County
590
Provider County Name
Madison
Ownership Type
Non profit - Corporation
Number of Certified Beds
45
Number of Residents in Certified Beds
39
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MID NEBRASKA LUTHERAN HOME ASSN
Date First Approved to Provide Medicare and Medicaid services
1997-05-05
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
4
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
2.46923
Reported LPN Staffing Hours per Resident per Day
0.63077
Reported RN Staffing Hours per Resident per Day
0.86538
Reported Licensed Staffing Hours per Resident per Day
1.49615
Reported Total Nurse Staffing Hours per Resident per Day
3.96538
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03077
Expected CNA Staffing Hours per Resident per Day
2.39141
Expected LPN Staffing Hours per Resident per Day
0.63460
Expected RN Staffing Hours per Resident per Day
0.98142
Expected Total Nurse Staffing Hours per Resident per Day
4.00743
Adjusted CNA Staffing Hours per Resident per Day
2.53354
Adjusted LPN Staffing Hours per Resident per Day
0.82500
Adjusted RN Staffing Hours per Resident per Day
0.65885
Adjusted Total Nurse Staffing Hours per Resident per Day
3.98860
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2015-02-09
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
7
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2014-01-13
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
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-10-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
37.33300
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
4
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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