Sheyenne Crossings Care Center/tcu - West Fargo Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
355124
Provider Name
SHEYENNE CROSSINGS CARE CENTER/TCU
Provider Address
125 13TH AVENUE WEST
WEST FARGO, ND 58078
WEST FARGO, ND 58078
Provider Phone Number
(701) 478-6100
Provider SSA County
80
Provider County Name
Cass
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
64
Number of Residents in Certified Beds
62
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EVENTIDE
Date First Approved to Provide Medicare and Medicaid services
2010-03-25
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
5
Overall Rating Footnote
Health Inspection Rating
3
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
3.23790
Reported LPN Staffing Hours per Resident per Day
0.98871
Reported RN Staffing Hours per Resident per Day
0.65081
Reported Licensed Staffing Hours per Resident per Day
1.63952
Reported Total Nurse Staffing Hours per Resident per Day
4.87742
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14274
Expected CNA Staffing Hours per Resident per Day
2.62952
Expected LPN Staffing Hours per Resident per Day
0.63901
Expected RN Staffing Hours per Resident per Day
1.00299
Expected Total Nurse Staffing Hours per Resident per Day
4.27153
Adjusted CNA Staffing Hours per Resident per Day
3.02140
Adjusted LPN Staffing Hours per Resident per Day
1.28422
Adjusted RN Staffing Hours per Resident per Day
0.48483
Adjusted Total Nurse Staffing Hours per Resident per Day
4.60266
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-04-08
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
36
Cycle 2 Standard Health Survey Date
2014-03-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
6
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2013-03-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
32.66700
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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