South Davis Community Care Center - Bountiful Nursing Home

General Information

UPDATE
Federal Provider Number
465062
Provider Name
SOUTH DAVIS COMMUNITY CARE CENTER
Provider Address
401 SOUTH 400 EAST
BOUNTIFUL, UT 84010
Provider Phone Number
8012952361
Provider SSA County
50
Provider County Name
Davis
Ownership Type
Non profit - Corporation
Number of Certified Beds
160
Number of Residents in Certified Beds
134
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
SOUTH DAVIS COMMUNITY HOSPITAL INC
Date First Approved to Provide Medicare and Medicaid services
1977-04-11
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
1
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
3.58619
Reported LPN Staffing Hours per Resident per Day
0.37836
Reported RN Staffing Hours per Resident per Day
2.53731
Reported Licensed Staffing Hours per Resident per Day
2.91567
Reported Total Nurse Staffing Hours per Resident per Day
6.50186
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15149
Expected CNA Staffing Hours per Resident per Day
2.67912
Expected LPN Staffing Hours per Resident per Day
1.05191
Expected RN Staffing Hours per Resident per Day
1.54603
Expected Total Nurse Staffing Hours per Resident per Day
5.27706
Adjusted CNA Staffing Hours per Resident per Day
3.28445
Adjusted LPN Staffing Hours per Resident per Day
0.29854
Adjusted RN Staffing Hours per Resident per Day
1.22629
Adjusted Total Nurse Staffing Hours per Resident per Day
4.96647
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2014-08-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-09-26
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
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-12-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
71.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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