Wibaux County Nursing Home - Wibaux Nursing Home
General Information
UPDATEFederal Provider Number
275079
Provider Name
WIBAUX COUNTY NURSING HOME
Provider Address
712 WIBAUX ST S
WIBAUX, MT 59353
WIBAUX, MT 59353
Provider Phone Number
4067962429
Provider SSA County
540
Provider County Name
Wibaux
Ownership Type
Government - County
Number of Certified Beds
40
Number of Residents in Certified Beds
29
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WIBAUX COUNTY NURSING HOMEOF WIBAUX MONTANA
Date First Approved to Provide Medicare and Medicaid services
1977-11-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
2
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
2.78621
Reported LPN Staffing Hours per Resident per Day
0.48103
Reported RN Staffing Hours per Resident per Day
0.54655
Reported Licensed Staffing Hours per Resident per Day
1.02759
Reported Total Nurse Staffing Hours per Resident per Day
3.81379
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00517
Expected CNA Staffing Hours per Resident per Day
2.55649
Expected LPN Staffing Hours per Resident per Day
0.62154
Expected RN Staffing Hours per Resident per Day
0.87834
Expected Total Nurse Staffing Hours per Resident per Day
4.05637
Adjusted CNA Staffing Hours per Resident per Day
2.67419
Adjusted LPN Staffing Hours per Resident per Day
0.64237
Adjusted RN Staffing Hours per Resident per Day
0.46495
Adjusted Total Nurse Staffing Hours per Resident per Day
3.78984
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-03-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-01-31
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-02-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
18.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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