Midtown Manor - Salt Lake City Nursing Home
General Information
UPDATEFederal Provider Number
465124
Provider Name
MIDTOWN MANOR
Provider Address
125 SOUTH 900 WEST
SALT LAKE CITY, UT 84104
SALT LAKE CITY, UT 84104
Provider Phone Number
(801) 363-6340
Provider SSA County
170
Provider County Name
Salt Lake
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
82
Number of Residents in Certified Beds
79
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ADAMS & ADAMS ENTERPRISES INC
Date First Approved to Provide Medicare and Medicaid services
1990-10-17
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.57152
Reported LPN Staffing Hours per Resident per Day
0.25949
Reported RN Staffing Hours per Resident per Day
1.04494
Reported Licensed Staffing Hours per Resident per Day
1.30443
Reported Total Nurse Staffing Hours per Resident per Day
3.87595
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08291
Expected CNA Staffing Hours per Resident per Day
2.64354
Expected LPN Staffing Hours per Resident per Day
0.77639
Expected RN Staffing Hours per Resident per Day
1.31769
Expected Total Nurse Staffing Hours per Resident per Day
4.73763
Adjusted CNA Staffing Hours per Resident per Day
2.38685
Adjusted LPN Staffing Hours per Resident per Day
0.27741
Adjusted RN Staffing Hours per Resident per Day
0.59254
Adjusted Total Nurse Staffing Hours per Resident per Day
3.29776
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-11-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
15
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
84
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-05-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
50.66700
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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