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Eventide Jamestown

Summary: Eventide Jamestown is located in Jamestown, North Dakota. It was first approved by Medicare and Medicaid to provide nursing home services on 1978-10-01. It currently has 115 certified beds and 100 residents in the certified beds. Eventide Jamestown earned a 2-star overall rating in the lasted Medicare and Medicaid Health Inspections (2015-08-01) [1]. See following table for more details.

Information of Eventide Jamestown

Nursing Home Profile
Address 1300 2ND PL NE, Jamestown, ND 58401
Phone 701-252-5881
Number Certified Beds / Residents in Certified Beds 115 / 100
Certification Medicare and Medicaid
Ratings
Overall Rating ★★ ☆☆☆ (2)  
Health Inspection Rating ☆☆☆☆ (1)
Quality Rating ★★★ ☆☆ (3)
Staffing Rating ★★★★ (4)
RN Staffing Rating ★★★★ (4)
Staff and Nurse Hour Statistics
Reported CNA Staffing Hours per Resident per Day 3.24600
Reported LPN Staffing Hours per Resident per Day 0.60050
Reported RN Staffing Hours per Resident per Day 0.64850
Reported Licensed Staffing Hours per Resident per Day 1.24900
Reported Total Nurse Staffing Hours per Resident per Day 4.49500
Reported Physical Therapist Staffing Hours per Resident Per Day 0.05350
Expected CNA Staffing Hours per Resident per Day 2.40731
Expected LPN Staffing Hours per Resident per Day 0.62358
Expected RN Staffing Hours per Resident per Day 0.93205
Expected Total Nurse Staffing Hours per Resident per Day 3.96294
Adjusted CNA Staffing Hours per Resident per Day 3.30855
Adjusted LPN Staffing Hours per Resident per Day 0.79928
Adjusted RN Staffing Hours per Resident per Day 0.51989
Adjusted Total Nurse Staffing Hours per Resident per Day 4.57208
Notes: CNA=Certified nurse attendant;   LPN=Licensed practical nurse
Health Deficiencies & Scores
Cycle 1 Total Number of Health Deficiencies 23
Cycle 1 Number of Standard Health Deficiencies 16
Cycle 1 Number of Complaint Health Deficiencies 7
Cycle 1 Health Deficiency Score 148
Cycle 1 Standard Survey Health Date 2014-11-20
Cycle 1 Number of Health Revisits 1
Cycle 1 Health Revisit Score 0
Cycle 1 Total Health Score 148
Cycle 2 Total Number of Health Deficiencies 22
Cycle 2 Number of Standard Health Deficiencies 22
Cycle 2 Number of Complaint Health Deficiencies 0
Cycle 2 Health Deficiency Score 152
Cycle 2 Standard Survey Health Date 2013-12-19
Cycle 2 Number of Health Revisits 1
Cycle 2 Health Revisit Score 0
Cycle 2 Total Health Score 152
Cycle 3 Total Number of Health Deficiencies 13
Cycle 3 Number of Standard Health Deficiencies 13
Cycle 3 Number of Complaint Health Deficiencies 0
Cycle 3 Health Deficiency Score 76
Cycle 3 Standard Survey Health Date 2013-01-10
Cycle 3 Number of Health Revisits 1
Cycle 3 Health Revisit Score 0
Cycle 2 Total Health Score 76
Total Weighted Health Survey Score 137.333
Complaints, Fines & Penalties
Number of Facility Reported Incidents 0
Number of Substantiated Complaints 1
Number of Fines 0
Total Amount of Fines in Dollars 0
Number of Payment Denials 0
Total Number of Penalties 0
Facility Information
Ownership Non profit - Corporation
Date First Approved to Provide Medicare and Medicaid 1978-10-01
Provider Resides in Hospital NO
Continuing Care Retirement Community N
Special Focus Facility N
Changed Ownership in Last 12 Months N
With a Resident and Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Processing Date 2015-08-01

Ownership Information

Owner NameOwner RoleOwner Type%
Eventide5% Or Greater Direct Ownership InterestOrganizationn/a
Brakke, AnneDirectorIndividualn/a
Dahlsad, HerbDirectorIndividualn/a
Edwards, DennisDirectorIndividualn/a
Erickstad, JohnDirectorIndividualn/a
Matthees, MarjorieDirectorIndividualn/a
Nelson, DuaneDirectorIndividualn/a
Nolting, VernDirectorIndividualn/a
Pingree, DonDirectorIndividualn/a
Riewer, JonDirectorIndividualn/a
Rogers, DavidDirectorIndividualn/a
Seljevold, PeterDirectorIndividualn/a
Stieha, DonDirectorIndividualn/a
Stubson, WadeDirectorIndividualn/a
Thompson, KennethDirectorIndividualn/a
Wright, LeannDirectorIndividualn/a
Riewer, JonManaging EmployeeIndividualn/a
Stubson, WadeManaging EmployeeIndividualn/a