Villa Maria - Fargo Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
355079
Provider Name
VILLA MARIA
Provider Address
3102 S UNIVERSITY DR
FARGO, ND 58103
FARGO, ND 58103
Provider Phone Number
(701) 293-7750
Provider SSA County
80
Provider County Name
Cass
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
140
Number of Residents in Certified Beds
135
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SISTERS OF MARY OF THE PRESENTATION LONG TERM CARE
Date First Approved to Provide Medicare and Medicaid services
1978-10-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
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
3.07778
Reported LPN Staffing Hours per Resident per Day
1.00630
Reported RN Staffing Hours per Resident per Day
0.62222
Reported Licensed Staffing Hours per Resident per Day
1.62852
Reported Total Nurse Staffing Hours per Resident per Day
4.70630
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04333
Expected CNA Staffing Hours per Resident per Day
2.51307
Expected LPN Staffing Hours per Resident per Day
0.58963
Expected RN Staffing Hours per Resident per Day
0.84459
Expected Total Nurse Staffing Hours per Resident per Day
3.94728
Adjusted CNA Staffing Hours per Resident per Day
3.00507
Adjusted LPN Staffing Hours per Resident per Day
1.41653
Adjusted RN Staffing Hours per Resident per Day
0.55047
Adjusted Total Nurse Staffing Hours per Resident per Day
4.80600
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-10-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-12-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-11-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
16.00000
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
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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