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Four Seasons Health Care Inc

Summary: Four Seasons Health Care Inc is located in Forman, North Dakota. It was first approved by Medicare and Medicaid to provide nursing home services on 1991-05-01. It currently has 32 certified beds and 29 residents in the certified beds. Four Seasons Health Care Inc earned a 5-star overall rating in the lasted Medicare and Medicaid Health Inspections (2015-08-01) [1]. See following table for more details.

Information of Four Seasons Health Care Inc

Nursing Home Profile
Address 483 4TH ST SW, Forman, ND 58032
Phone 701-724-6211
Number Certified Beds / Residents in Certified Beds 32 / 29
Certification Medicare and Medicaid
Ratings
Overall Rating ★★★★★ (5)  
Health Inspection Rating ★★★★★ (5)
Quality Rating ★★ ☆☆☆ (2)
Staffing Rating ★★★★ (4)
RN Staffing Rating ★★★★ (4)
Staff and Nurse Hour Statistics
Reported CNA Staffing Hours per Resident per Day 2.60345
Reported LPN Staffing Hours per Resident per Day 0.59655
Reported RN Staffing Hours per Resident per Day 0.65862
Reported Licensed Staffing Hours per Resident per Day 1.25517
Reported Total Nurse Staffing Hours per Resident per Day 3.85862
Reported Physical Therapist Staffing Hours per Resident Per Day 0.00172
Expected CNA Staffing Hours per Resident per Day 2.18107
Expected LPN Staffing Hours per Resident per Day 0.60046
Expected RN Staffing Hours per Resident per Day 0.86976
Expected Total Nurse Staffing Hours per Resident per Day 3.65129
Adjusted CNA Staffing Hours per Resident per Day 2.92888
Adjusted LPN Staffing Hours per Resident per Day 0.82459
Adjusted RN Staffing Hours per Resident per Day 0.56581
Adjusted Total Nurse Staffing Hours per Resident per Day 4.25978
Notes: CNA=Certified nurse attendant;   LPN=Licensed practical nurse
Health Deficiencies & Scores
Cycle 1 Total Number of Health Deficiencies 2
Cycle 1 Number of Standard Health Deficiencies 2
Cycle 1 Number of Complaint Health Deficiencies 0
Cycle 1 Health Deficiency Score 12
Cycle 1 Standard Survey Health Date 2014-10-16
Cycle 1 Number of Health Revisits 1
Cycle 1 Health Revisit Score 0
Cycle 1 Total Health Score 12
Cycle 2 Total Number of Health Deficiencies 1
Cycle 2 Number of Standard Health Deficiencies 1
Cycle 2 Number of Complaint Health Deficiencies 0
Cycle 2 Health Deficiency Score 4
Cycle 2 Standard Survey Health Date 2013-10-31
Cycle 2 Number of Health Revisits 1
Cycle 2 Health Revisit Score 0
Cycle 2 Total Health Score 4
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 20
Cycle 3 Standard Survey Health Date 2012-11-08
Cycle 3 Number of Health Revisits 1
Cycle 3 Health Revisit Score 0
Cycle 2 Total Health Score 20
Total Weighted Health Survey Score 10.667
Complaints, Fines & Penalties
Number of Facility Reported Incidents 0
Number of Substantiated Complaints 0
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 1991-05-01
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%
Ellefson, PattyOfficerIndividualn/a
Johnson, DeborahOfficerIndividualn/a
Martinson, DavidOfficerIndividualn/a
Mclean, StevenOfficerIndividualn/a
Rockswold, JasonOfficerIndividualn/a
Schlecht, NathanOfficerIndividualn/a
Woytassek, Mary KayOfficerIndividualn/a
Kleingartner, AndreaManaging EmployeeIndividualn/a
Lang, SonyaManaging EmployeeIndividualn/a