Provider Name: AVERA BORMANN MANOR
Address: 501 NORTH 4TH STREET, PARKSTON, SD 57366
Phone: (605) 928-3384
County: Hutchinson (330)
Ownership Type: Non profit - Corporation
Certified Beds: 49
Average Residents Per Day: 48.2 ()
Provider Type: Medicaid, Resides in Hospital: No
Legal Business Name: Legal Business Name Not Available
First Approved Date: July 1, 2011
Affiliated Entity: ()
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Resident
Sprinkler System Status: Yes
Overall Rating: 4 ()
Health Inspection Rating: 4 ()
QM Rating: 3 ()
Long Stay QM Rating: 3 ()
Short Stay QM Rating: (2)
Staffing Rating: 4 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.03924, LPN Staff Hours Per Day: 0.1083, RN Staff Hours Per Day: 0.9540, Licensed Staff Hours Per Day: 1.0623
Total Nurse Staff Hours Per Day, per resident: 3.10156
Weekend Nurse Staff Hours: 2.56998, Weekend RN Staff Hours: 0.5052
PT Staff Hours Per Day, per resident: 0.0000
Nurse Staff Turnover: 47.6, Nurse Turnover Note:
RN Turnover: 30.0, RN Turnover Note:
Admin Left Number: , Admin Turnover Note: 6
Case Mix Nurse Aide Hours Per Day, per resident: 1.8980, Case Mix LPN Hours Per Day: 0.6223, Case Mix RN Hours Per Day: 0.2718
Adjusted Nurse Aide Hours Per Day, per resident: 2.18876, Adjusted LPN Hours Per Day: 0.1284, Adjusted RN Hours Per Day: 1.3221
Total Adjusted Nurse Hours Per Day, per resident: 3.50119
Adjusted Weekend Nurse Hours Per Day, per resident: 2.90112
Health Survey Dates and Scores: Cycle 1: 2023-06-08 (Score: 8), Cycle 2: 2022-01-20 (Score: 8), Cycle 3: 2019-05-15 (Score: 16)
Total Weighted Health Score: 9.333
Reported Incidents: 0, Substantiated Complaints: 0
Infection Control Citations: 0
Fines and Penalties: Number of Fines: 0, Total Fines in Dollars: 0.00, Payment Denials Number: 0, Total Penalties Number: 0
Location and GPS: 501 NORTH 4TH STREET,PARKSTON,SD,57366 (43.3989, -97.990)
Process Date: 2024-03-01
Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Health, Deficiency: Keep residents' personal and medical records private and confidential.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-07-27
Type: Health, Deficiency: Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-03-11
Type: Health, Deficiency: Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-07-04
Type: Health, Deficiency: Provide and implement an infection prevention and control program.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-07-04
Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Fire Safety, Tag: 0226, Version: New
Description: Have horizontal exits used in accordance with safety requirements.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-07-07
Type: Fire Safety, Tag: 0712, Version: New
Description: Have simulated fire drills held at unexpected times.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-07-13
Type: Fire Safety, Tag: 0353, Version: New
Description: Inspect, test, and maintain automatic sprinkler systems.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-05-28
Type: Fire Safety, Tag: 0919, Version: New
Description: Meet requirements for the use of electrical equipment.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-05-22