TABITHA AT PRAIRIE COMMONS Nursing Home

TABITHA AT PRAIRIE COMMONS Summary

Provider Name: TABITHA AT PRAIRIE COMMONS

Address: 3490 EWOLDT STREET, GRAND ISLAND, NE 68803

Phone: (308) 321-1122

County: Hall (390)

Ownership Type: Non profit - Corporation

Certified Beds: 36

Average Residents Per Day: 11.1 ()

Provider Type: Medicare and Medicaid, Resides in Hospital: No

Legal Business Name: TABITHA GRAND ISLAND, INC

First Approved Date: April 12, 2023

Affiliated Entity: ()

Retirement Community: N, Special Focus Status:

Ownership Change in Last 12 Months: N

Resident Family Council: None

Sprinkler System Status: Yes

Overall Rating: (1)

Health Inspection Rating: (1)

QM Rating: (1)

Long Stay QM Rating: (1)

Short Stay QM Rating: (1)

Staffing Rating: (1)

Staffing Report Note:

PT Staffing Note:

Nurse Aide Staff Hours Per Day, per resident: 4.67241, LPN Staff Hours Per Day: 1.6011, RN Staff Hours Per Day: 2.5885, Licensed Staff Hours Per Day: 4.1897

Total Nurse Staff Hours Per Day, per resident: 8.86211

Weekend Nurse Staff Hours: 6.84642, Weekend RN Staff Hours: 2.1193

PT Staff Hours Per Day, per resident: 0.0000

Nurse Staff Turnover: , Nurse Turnover Note: 6

RN Turnover: , RN Turnover Note: 6

Admin Left Number: , Admin Turnover Note: 6

Case Mix Nurse Aide Hours Per Day, per resident: 2.2656, Case Mix LPN Hours Per Day: 0.7314, Case Mix RN Hours Per Day: 0.2910

Adjusted Nurse Aide Hours Per Day, per resident: , Adjusted LPN Hours Per Day: , Adjusted RN Hours Per Day:

Total Adjusted Nurse Hours Per Day, per resident:

Adjusted Weekend Nurse Hours Per Day, per resident:

Health Survey Dates and Scores: Cycle 1: 2023-04-12 (Score: .), Cycle 2: (Score: .), Cycle 3: (Score: .)

Total Weighted Health Score:

Reported Incidents: 0, Substantiated Complaints: 0

Infection Control Citations:

Fines and Penalties: Number of Fines: 0, Total Fines in Dollars: 0.00, Payment Denials Number: 0, Total Penalties Number: 0

Location and GPS: 3490 EWOLDT STREET,GRAND ISLAND,NE,68803 (40.9266, -98.377)

Process Date: 2024-03-01