Mountrail Bethel Home - Stanley Nursing Home
General Information
UPDATEFederal Provider Number
355044
Provider Name
MOUNTRAIL BETHEL HOME
Provider Address
615 6TH ST SE
STANLEY, ND 58784
STANLEY, ND 58784
Provider Phone Number
7016282442
Provider SSA County
300
Provider County Name
Mountrail
Ownership Type
Non profit - Church related
Number of Certified Beds
52
Number of Residents in Certified Beds
46
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MOUNTRAIL BETHEL HOME, INC.
Date First Approved to Provide Medicare and Medicaid services
1978-06-01
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
2
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
3.17391
Reported LPN Staffing Hours per Resident per Day
0.90978
Reported RN Staffing Hours per Resident per Day
0.92391
Reported Licensed Staffing Hours per Resident per Day
1.83370
Reported Total Nurse Staffing Hours per Resident per Day
5.00760
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15543
Expected CNA Staffing Hours per Resident per Day
2.29109
Expected LPN Staffing Hours per Resident per Day
0.66681
Expected RN Staffing Hours per Resident per Day
0.89051
Expected Total Nurse Staffing Hours per Resident per Day
3.84841
Adjusted CNA Staffing Hours per Resident per Day
3.39918
Adjusted LPN Staffing Hours per Resident per Day
1.13243
Adjusted RN Staffing Hours per Resident per Day
0.77523
Adjusted Total Nurse Staffing Hours per Resident per Day
5.24506
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-08-06
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
14
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-08-15
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
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-08-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
50.00000
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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