Missoula Health & Rehabilitation Center - Missoula Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
275035
Provider Name
MISSOULA HEALTH & REHABILITATION CENTER
Provider Address
3018 RATTLESNAKE DR
MISSOULA, MT 59802
MISSOULA, MT 59802
Provider Phone Number
(406) 549-0988
Provider SSA County
310
Provider County Name
Missoula
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
53
Number of Residents in Certified Beds
35
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EVERGREEN AT MISSOULA, L.L.C.
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
2
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
2.47286
Reported LPN Staffing Hours per Resident per Day
0.34714
Reported RN Staffing Hours per Resident per Day
1.20714
Reported Licensed Staffing Hours per Resident per Day
1.55429
Reported Total Nurse Staffing Hours per Resident per Day
4.02714
Reported Physical Therapist Staffing Hours per Resident Per Day
0.19000
Expected CNA Staffing Hours per Resident per Day
2.21989
Expected LPN Staffing Hours per Resident per Day
0.57548
Expected RN Staffing Hours per Resident per Day
0.85696
Expected Total Nurse Staffing Hours per Resident per Day
3.65233
Adjusted CNA Staffing Hours per Resident per Day
2.73332
Adjusted LPN Staffing Hours per Resident per Day
0.50067
Adjusted RN Staffing Hours per Resident per Day
1.05253
Adjusted Total Nurse Staffing Hours per Resident per Day
4.44455
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
44
Cycle 1 Standard Survey Health Date
2014-11-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-11-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
120
Cycle 3 Standard Health Survey Date
2012-10-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
120
Total Weighted Health Survey Score
48.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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