Promontory Point Rehabilitation - Ammon Nursing Home
General Information
UPDATEFederal Provider Number
135137
Provider Name
PROMONTORY POINT REHABILITATION
Provider Address
3909 SOUTH 25TH EAST
AMMON, ID 83406
AMMON, ID 83406
Provider Phone Number
2085284000
Provider SSA County
90
Provider County Name
Bonneville
Ownership Type
For profit - Limited Liability
Number of Certified Beds
30
Number of Residents in Certified Beds
27
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
SNF AMMON OPERATING COMPANY LLC.
Date First Approved to Provide Medicare and Medicaid services
2010-10-14
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
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
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.14815
Reported LPN Staffing Hours per Resident per Day
1.00556
Reported RN Staffing Hours per Resident per Day
0.73333
Reported Licensed Staffing Hours per Resident per Day
1.73889
Reported Total Nurse Staffing Hours per Resident per Day
4.88704
Reported Physical Therapist Staffing Hours per Resident Per Day
0.75370
Expected CNA Staffing Hours per Resident per Day
2.20289
Expected LPN Staffing Hours per Resident per Day
0.66214
Expected RN Staffing Hours per Resident per Day
1.42379
Expected Total Nurse Staffing Hours per Resident per Day
4.28881
Adjusted CNA Staffing Hours per Resident per Day
3.50659
Adjusted LPN Staffing Hours per Resident per Day
1.26049
Adjusted RN Staffing Hours per Resident per Day
0.38485
Adjusted Total Nurse Staffing Hours per Resident per Day
4.59315
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2015-03-13
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
17
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
116
Cycle 2 Standard Health Survey Date
2013-12-20
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
12
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-10-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
94.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
975
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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