Powder River Manor - Broadus Nursing Home
General Information
UPDATEFederal Provider Number
275087
Provider Name
POWDER RIVER MANOR
Provider Address
104 N TRAUTMAN
BROADUS, MT 59317
BROADUS, MT 59317
Provider Phone Number
4064362646
Provider SSA County
370
Provider County Name
Powder River
Ownership Type
Government - County
Number of Certified Beds
41
Number of Residents in Certified Beds
31
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
POWDER RIVER COUNTY
Date First Approved to Provide Medicare and Medicaid services
1977-09-12
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
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.18871
Reported LPN Staffing Hours per Resident per Day
0.02742
Reported RN Staffing Hours per Resident per Day
1.07097
Reported Licensed Staffing Hours per Resident per Day
1.09839
Reported Total Nurse Staffing Hours per Resident per Day
3.28710
Reported Physical Therapist Staffing Hours per Resident Per Day
0.20000
Expected CNA Staffing Hours per Resident per Day
2.22734
Expected LPN Staffing Hours per Resident per Day
0.57463
Expected RN Staffing Hours per Resident per Day
0.78417
Expected Total Nurse Staffing Hours per Resident per Day
3.58614
Adjusted CNA Staffing Hours per Resident per Day
2.41115
Adjusted LPN Staffing Hours per Resident per Day
0.03961
Adjusted RN Staffing Hours per Resident per Day
1.02048
Adjusted Total Nurse Staffing Hours per Resident per Day
3.69477
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-07-31
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
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
104
Cycle 2 Standard Health Survey Date
2013-06-20
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-07-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
57.33300
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
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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