Miller Memorial Care Center, Llc - Chappell Nursing Home
General Information
UPDATEFederal Provider Number
280000000000000000000000000000
Provider Name
MILLER MEMORIAL CARE CENTER, LLC
Provider Address
P O BOX 428, 589 VINCENT AVENUE
CHAPPELL, NE 69129
CHAPPELL, NE 69129
Provider Phone Number
3088742291
Provider SSA County
240
Provider County Name
Deuel
Ownership Type
For profit - Individual
Number of Certified Beds
24
Number of Residents in Certified Beds
17
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
2002-11-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
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
2.53529
Reported LPN Staffing Hours per Resident per Day
1.17647
Reported RN Staffing Hours per Resident per Day
0.89412
Reported Licensed Staffing Hours per Resident per Day
2.07059
Reported Total Nurse Staffing Hours per Resident per Day
4.60588
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.42147
Expected LPN Staffing Hours per Resident per Day
0.53529
Expected RN Staffing Hours per Resident per Day
0.71382
Expected Total Nurse Staffing Hours per Resident per Day
3.67059
Adjusted CNA Staffing Hours per Resident per Day
2.56903
Adjusted LPN Staffing Hours per Resident per Day
1.82417
Adjusted RN Staffing Hours per Resident per Day
0.93593
Adjusted Total Nurse Staffing Hours per Resident per Day
5.05800
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
120
Cycle 1 Standard Survey Health Date
2015-01-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
120
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2014-02-20
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
12
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2013-02-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
96.00000
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
10
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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