Trinity Mission Health & Rehab Of Holly - Nampa Nursing Home
General Information
UPDATEFederal Provider Number
135094
Provider Name
TRINITY MISSION HEALTH & REHAB OF HOLLY
Provider Address
2105 12TH AVENUE ROAD
NAMPA, ID 83686
NAMPA, ID 83686
Provider Phone Number
(208) 467-5721
Provider SSA County
130
Provider County Name
Canyon
Provider Website
Provider Description
Ownership Type
For profit - Limited Liability
Number of Certified Beds
120
Number of Residents in Certified Beds
92
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRINITY MISSION HEALTH & REHAB OF HOLLY, LLC
Date First Approved to Provide Medicare and Medicaid services
1983-09-09
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
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
3.12500
Reported LPN Staffing Hours per Resident per Day
1.49076
Reported RN Staffing Hours per Resident per Day
0.83859
Reported Licensed Staffing Hours per Resident per Day
2.32935
Reported Total Nurse Staffing Hours per Resident per Day
5.45435
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12446
Expected CNA Staffing Hours per Resident per Day
2.54238
Expected LPN Staffing Hours per Resident per Day
0.81245
Expected RN Staffing Hours per Resident per Day
1.29924
Expected Total Nurse Staffing Hours per Resident per Day
4.65407
Adjusted CNA Staffing Hours per Resident per Day
3.01600
Adjusted LPN Staffing Hours per Resident per Day
1.52296
Adjusted RN Staffing Hours per Resident per Day
0.48228
Adjusted Total Nurse Staffing Hours per Resident per Day
4.72403
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2014-01-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
88
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
15
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2012-11-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2011-07-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
74.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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