Rocky Mountain Care - Evanston - Evanston Nursing Home
General Information
UPDATEFederal Provider Number
535038
Provider Name
ROCKY MOUNTAIN CARE - EVANSTON
Provider Address
475 YELLOW CREEK ROAD
EVANSTON, WY 82930
EVANSTON, WY 82930
Provider Phone Number
(307) 789-0726
Provider SSA County
200
Provider County Name
Uinta
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
40
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ROCKY MOUNTAIN CARE EVANSTON INC
Date First Approved to Provide Medicare and Medicaid services
1989-09-19
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
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.39000
Reported LPN Staffing Hours per Resident per Day
0.76125
Reported RN Staffing Hours per Resident per Day
0.68250
Reported Licensed Staffing Hours per Resident per Day
1.44375
Reported Total Nurse Staffing Hours per Resident per Day
3.83375
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07125
Expected CNA Staffing Hours per Resident per Day
2.66746
Expected LPN Staffing Hours per Resident per Day
0.75648
Expected RN Staffing Hours per Resident per Day
1.08067
Expected Total Nurse Staffing Hours per Resident per Day
4.50461
Adjusted CNA Staffing Hours per Resident per Day
2.19847
Adjusted LPN Staffing Hours per Resident per Day
0.83524
Adjusted RN Staffing Hours per Resident per Day
0.47189
Adjusted Total Nurse Staffing Hours per Resident per Day
3.43059
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
20
Cycle 1 Standard Survey Health Date
2015-01-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-11-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
84
Cycle 3 Total Number of Health Deficiencies
18
Cycle 3 Number of Standard Health Deficiencies
18
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
92
Cycle 3 Standard Health Survey Date
2012-09-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
92
Total Weighted Health Survey Score
53.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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