Utica Community Care Center - Utica Nursing Home

General Information

UPDATE
Federal Provider Number
285161
Provider Name
UTICA COMMUNITY CARE CENTER
Provider Address
1350 CENTENNIAL AVENUE
UTICA, NE 68456
Provider Phone Number
4025342041
Provider SSA County
790
Provider County Name
Seward
Ownership Type
For profit - Corporation
Number of Certified Beds
41
Number of Residents in Certified Beds
30
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FIVE STAR QUALITY CARE - NE INC
Date First Approved to Provide Medicare and Medicaid services
1995-04-12
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
1
QM Rating Footnote
Staffing Rating
4
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
2.52000
Reported LPN Staffing Hours per Resident per Day
0.45667
Reported RN Staffing Hours per Resident per Day
0.76000
Reported Licensed Staffing Hours per Resident per Day
1.21667
Reported Total Nurse Staffing Hours per Resident per Day
3.73667
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02167
Expected CNA Staffing Hours per Resident per Day
2.34528
Expected LPN Staffing Hours per Resident per Day
0.67857
Expected RN Staffing Hours per Resident per Day
0.91663
Expected Total Nurse Staffing Hours per Resident per Day
3.94048
Adjusted CNA Staffing Hours per Resident per Day
2.63650
Adjusted LPN Staffing Hours per Resident per Day
0.55858
Adjusted RN Staffing Hours per Resident per Day
0.61952
Adjusted Total Nurse Staffing Hours per Resident per Day
3.82242
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
10
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-05-28
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
12
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
76
Cycle 2 Standard Health Survey Date
2013-04-30
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-04-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
61.33300
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
4
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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