Sunset Drive - A Prospera Community
1011 Boundary St Nw, Mandan, ND 58554


Sunset Drive - A Prospera Community is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 355065. The address is 1011 Boundary St Nw, Mandan, ND 58554. The zip code is 58554. The phone number is 7013231411.


Sunset Drive - A Prospera Community · 1011 Boundary St Nw, Mandan, ND 58554

Federal Provider Number 355065
Provider Name SUNSET DRIVE - A PROSPERA COMMUNITY
Address 1011 BOUNDARY ST NW
MANDAN, ND 58554
Phone Number 7013231411
SSA County Code 290
County Name Morton
Ownership Type Non profit - Corporation
Certified Beds 128
Certified Beds Residents 127
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name SANFORD GOOD SAMARITAN COMMUNITY HEALTH SERVICES LLC
Date First Approved to Provide Medicare Medicaid Services 07/01/1978
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months true
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 4
Health Inspection Rating 2
Quality Measure Rating 5
Staffing Rating 5
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 3.83976
Reported LPN Staffing Hours per Resident per Day 0.50709
Reported RN Staffing Hours per Resident per Day 0.90197
Reported Licensed Staffing Hours per Resident per Day 1.40906
Reported Total Nurse Staffing Hours per Resident per Day 5.24882
Reported Physical Therapist Staffing Hours per Resident Per Day 0.04449
Expected CNA Staffing Hours per Resident per Day 2.55397
Expected LPN Staffing Hours per Resident per Day 0.63836
Expected RN Staffing Hours per Resident per Day 0.92733
Expected Total Nurse Staffing Hours per Resident per Day 4.11965
Adjusted CNA Staffing Hours per Resident per Day 3.68902
Adjusted LPN Staffing Hours per Resident per Day 0.65933
Adjusted RN Staffing Hours per Resident per Day 0.72677
Adjusted Total Nurse Staffing Hours per Resident per Day 5.13575
Cycle 1 Total Number of Health Deficiencies 12
Cycle 1 Number of Standard Health Deficiencies 12
Cycle 1 Health Deficiency Score 60
Cycle 1 Standard Survey Health Date 02/23/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 60
Cycle 2 Total Number of Health Deficiencies 6
Cycle 2 Number of Standard Health Deficiencies 6
Cycle 2 Health Deficiency Score 36
Cycle 2 Standard Health Survey Date 04/14/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 36
Cycle 3 Total Number of Health Deficiencies 4
Cycle 3 Number of Standard Health Deficiencies 4
Cycle 3 Health Deficiency Score 8
Cycle 3 Standard Health Survey Date 03/18/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 8
Total Weighted Health Survey Score 43.333
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Sunset Drive - A Prospera Community

Owner Name Role Association Date
CRISTY, KIRK (Individual) DIRECTOR since 01/01/2017
ELSPERGER, ANTHONY (Individual) MANAGING EMPLOYEE since 01/01/2017
GRAYBILL, CLINT (Individual) DIRECTOR since 01/01/2017
HAM-QUICK, MISTY (Individual) OFFICER since 01/01/2017
HORAZDOVSKY, DAVID (Individual) OFFICER since 01/01/2017
LAMBRECHT, CRAIG (Individual) DIRECTOR since 01/01/2017
LAMBRECHT, CRAIG (Individual) OFFICER since 01/01/2017
PETERSON, BERGEN (Individual) DIRECTOR since 01/01/2017
PETERSON, WADE (Individual) MANAGING EMPLOYEE since 01/01/2017
SANFORD GOOD SAMARITAN COMMUNITY HEALTH SERVICES LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 01/01/2017
SANFORD GOOD SAMARITAN COMMUNITY HEALTH SERVICES LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 01/01/2017
SANFORD LIVING CENTERS (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
50%
since 01/01/2017
SYVERSON, THOMAS (Individual) DIRECTOR since 01/01/2017
SYVERSON, THOMAS (Individual) OFFICER since 01/01/2017
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
50%
since 01/01/2017
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (Organization) OPERATIONAL/MANAGERIAL CONTROL since 01/01/2017
TRIBBLE, GEORGE (Individual) DIRECTOR since 01/01/2017
TRIBBLE, GEORGE (Individual) OFFICER since 01/01/2017

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