Idaho Nursing Homes >> Blackfoot Nursing Homes >> Syringa Chalet Nursing Facility

Syringa Chalet Nursing Facility - Blackfoot Nursing Home

General Information

UPDATE
Federal Provider Number
135111
Provider Name
SYRINGA CHALET NURSING FACILITY
Provider Address
700 EAST ALICE STREET (83221-4925)
BLACKFOOT, ID 83221
Provider Phone Number
(208) 785-1200
Provider SSA County
50
Provider County Name
Bingham
Provider Website
Provider Description
Ownership Type
Government - State
Number of Certified Beds
29
Number of Residents in Certified Beds
22
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
STATE OF IDAHO DEPARTMENT OF HEALTH AND WELFARE
Date First Approved to Provide Medicare and Medicaid services
1990-03-12
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
2
QM Rating Footnote
Staffing Rating
0
Staffing Rating Footnote
Data Not Available
RN Staffing Rating
0
RN Staffing Rating Footnote
Data Not Available
Reported Staffing Footnote
Staffing Values not Reported because of Data Quality Concerns
Physical Therapist Staffing Footnote
Physical Therapy Staffing Values not Reported because of Data Quality Concerns
Reported CNA Staffing Hours per Resident per Day
0.00000
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
0.00000
Reported Licensed Staffing Hours per Resident per Day
0.00000
Reported Total Nurse Staffing Hours per Resident per Day
0.00000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.16020
Expected LPN Staffing Hours per Resident per Day
0.56353
Expected RN Staffing Hours per Resident per Day
0.79653
Expected Total Nurse Staffing Hours per Resident per Day
3.52027
Adjusted CNA Staffing Hours per Resident per Day
0.00000
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.00000
Adjusted Total Nurse Staffing Hours per Resident per Day
0.00000
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-03-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
104
Cycle 2 Standard Health Survey Date
2013-02-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
104
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2011-10-11
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
34
Cycle 3 Total Health Score
102
Total Weighted Health Survey Score
77.66700
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
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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