Providence Benedictine Nc - Mount Angel Nursing Home
General Information
UPDATEFederal Provider Number
385018
Provider Name
PROVIDENCE BENEDICTINE NC
Provider Address
540 SOUTH MAIN STREET
MOUNT ANGEL, OR 97362
MOUNT ANGEL, OR 97362
Provider Phone Number
(503) 845-6841
Provider SSA County
230
Provider County Name
Marion
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
93
Number of Residents in Certified Beds
93
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PROVIDENCE HEALTH & SERVICES-OREGON
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
3.28495
Reported LPN Staffing Hours per Resident per Day
0.20161
Reported RN Staffing Hours per Resident per Day
1.34086
Reported Licensed Staffing Hours per Resident per Day
1.54247
Reported Total Nurse Staffing Hours per Resident per Day
4.82742
Reported Physical Therapist Staffing Hours per Resident Per Day
0.22097
Expected CNA Staffing Hours per Resident per Day
2.54883
Expected LPN Staffing Hours per Resident per Day
0.65908
Expected RN Staffing Hours per Resident per Day
1.05222
Expected Total Nurse Staffing Hours per Resident per Day
4.26013
Adjusted CNA Staffing Hours per Resident per Day
3.16234
Adjusted LPN Staffing Hours per Resident per Day
0.25389
Adjusted RN Staffing Hours per Resident per Day
0.95217
Adjusted Total Nurse Staffing Hours per Resident per Day
4.56766
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-01-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2012-05-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2011-01-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
31.33300
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
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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