Trinity Mission Health And Rehab Of Provo - Provo Nursing Home

General Information

UPDATE
Federal Provider Number
465082
Provider Name
TRINITY MISSION HEALTH AND REHAB OF PROVO
Provider Address
1053 WEST 1020 SOUTH
PROVO, UT 84601
Provider Phone Number
8013732630
Provider SSA County
240
Provider County Name
Utah
Ownership Type
For profit - Limited Liability
Number of Certified Beds
99
Number of Residents in Certified Beds
61
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRINITY MISSION HEALTH & REHAB OF PROVO, LLC
Date First Approved to Provide Medicare and Medicaid services
1981-08-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.00410
Reported LPN Staffing Hours per Resident per Day
0.82623
Reported RN Staffing Hours per Resident per Day
0.92951
Reported Licensed Staffing Hours per Resident per Day
1.75574
Reported Total Nurse Staffing Hours per Resident per Day
3.75984
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02131
Expected CNA Staffing Hours per Resident per Day
2.20640
Expected LPN Staffing Hours per Resident per Day
0.70750
Expected RN Staffing Hours per Resident per Day
1.25203
Expected Total Nurse Staffing Hours per Resident per Day
4.16593
Adjusted CNA Staffing Hours per Resident per Day
2.22872
Adjusted LPN Staffing Hours per Resident per Day
0.96929
Adjusted RN Staffing Hours per Resident per Day
0.55472
Adjusted Total Nurse Staffing Hours per Resident per Day
3.63797
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-06-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
19
Cycle 2 Number of Standard Health Deficiencies
17
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
172
Cycle 2 Standard Health Survey Date
2013-05-16
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
17
Cycle 3 Number of Standard Health Deficiencies
17
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2011-02-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
104.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
Number of Fines
3
Total Amount of Fines in Dollars
3965
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01

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