William E Christofferson Salt Lake Veterans Home - Salt Lake City Nursing Home
General Information
UPDATEFederal Provider Number
465150
Provider Name
WILLIAM E CHRISTOFFERSON SALT LAKE VETERANS HOME
Provider Address
700 SOUTH FOOTHILL DRIVE
SALT LAKE CITY, UT 84113
SALT LAKE CITY, UT 84113
Provider Phone Number
(801) 584-1900
Provider SSA County
170
Provider County Name
Salt Lake
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
81
Number of Residents in Certified Beds
77
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AVALON CARE CENTER - VA SALT LAKE II LLC
Date First Approved to Provide Medicare and Medicaid services
2000-09-21
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
4
Health Inspection Rating Footnote
QM Rating
5
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
2.98506
Reported LPN Staffing Hours per Resident per Day
0.72987
Reported RN Staffing Hours per Resident per Day
0.87078
Reported Licensed Staffing Hours per Resident per Day
1.60065
Reported Total Nurse Staffing Hours per Resident per Day
4.58571
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02792
Expected CNA Staffing Hours per Resident per Day
2.59982
Expected LPN Staffing Hours per Resident per Day
0.62652
Expected RN Staffing Hours per Resident per Day
0.92326
Expected Total Nurse Staffing Hours per Resident per Day
4.14959
Adjusted CNA Staffing Hours per Resident per Day
2.81729
Adjusted LPN Staffing Hours per Resident per Day
0.96692
Adjusted RN Staffing Hours per Resident per Day
0.70473
Adjusted Total Nurse Staffing Hours per Resident per Day
4.45454
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-03-19
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
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2014-04-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2013-03-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
25.33300
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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