Wedgewood Manor - Cavalier Nursing Home
General Information
UPDATEFederal Provider Number
355087
Provider Name
WEDGEWOOD MANOR
Provider Address
804 MAIN ST W
CAVALIER, ND 58220
CAVALIER, ND 58220
Provider Phone Number
7012658453
Provider SSA County
330
Provider County Name
Pembina
Ownership Type
Non profit - Other
Number of Certified Beds
50
Number of Residents in Certified Beds
39
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PEMBINA COUNTY MEMORIAL HOSPITAL ASSOCIATION
Date First Approved to Provide Medicare and Medicaid services
1980-03-06
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
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
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
2.58718
Reported LPN Staffing Hours per Resident per Day
0.72179
Reported RN Staffing Hours per Resident per Day
0.48974
Reported Licensed Staffing Hours per Resident per Day
1.21154
Reported Total Nurse Staffing Hours per Resident per Day
3.79871
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02949
Expected CNA Staffing Hours per Resident per Day
2.43814
Expected LPN Staffing Hours per Resident per Day
0.62043
Expected RN Staffing Hours per Resident per Day
0.86823
Expected Total Nurse Staffing Hours per Resident per Day
3.92680
Adjusted CNA Staffing Hours per Resident per Day
2.60369
Adjusted LPN Staffing Hours per Resident per Day
0.96560
Adjusted RN Staffing Hours per Resident per Day
0.42147
Adjusted Total Nurse Staffing Hours per Resident per Day
3.89941
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-08-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
76
Cycle 2 Standard Health Survey Date
2013-07-18
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-06-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
38.00000
Number of Facility Reported Incidents
0
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
Nursiong Homes Nearby
Pembilier Nursing Center
500 Delano Ave |
WALHALLA ND 58282 | 15.8 miles away
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