Sarah Ann Hester Memorial Home - Benkelman Nursing Home
General Information
UPDATEFederal Provider Number
285241
Provider Name
SARAH ANN HESTER MEMORIAL HOME
Provider Address
P O BOX 646, 407 DAKOTA STREET
BENKELMAN, NE 69021
BENKELMAN, NE 69021
Provider Phone Number
3084232179
Provider SSA County
280
Provider County Name
Dundy
Ownership Type
Non profit - Corporation
Number of Certified Beds
56
Number of Residents in Certified Beds
33
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SARAH ANN HESTER MEMORIAL HOME
Date First Approved to Provide Medicare and Medicaid services
2001-11-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
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
2.22121
Reported LPN Staffing Hours per Resident per Day
0.58485
Reported RN Staffing Hours per Resident per Day
0.55303
Reported Licensed Staffing Hours per Resident per Day
1.13788
Reported Total Nurse Staffing Hours per Resident per Day
3.35909
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02424
Expected CNA Staffing Hours per Resident per Day
2.12965
Expected LPN Staffing Hours per Resident per Day
0.58116
Expected RN Staffing Hours per Resident per Day
0.94002
Expected Total Nurse Staffing Hours per Resident per Day
3.65083
Adjusted CNA Staffing Hours per Resident per Day
2.55919
Adjusted LPN Staffing Hours per Resident per Day
0.83527
Adjusted RN Staffing Hours per Resident per Day
0.43959
Adjusted Total Nurse Staffing Hours per Resident per Day
3.70879
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
36
Cycle 1 Standard Survey Health Date
2014-08-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
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
20
Cycle 2 Standard Health Survey Date
2013-08-28
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
22
Cycle 3 Number of Standard Health Deficiencies
22
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
220
Cycle 3 Standard Health Survey Date
2012-08-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
220
Total Weighted Health Survey Score
61.33300
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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