Millcreek Rehabilitation and Nursing, LLC
3520 South Highland Drive, Salt Lake City, UT 84106


Millcreek Rehabilitation and Nursing, LLC is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 465185. The address is 3520 South Highland Drive, Salt Lake City, UT 84106. The zip code is 84106. The phone number is 8014847638.


Millcreek Rehabilitation and Nursing, LLC · 3520 South Highland Drive, Salt Lake City, UT 84106

Federal Provider Number 465185
Provider Name MILLCREEK REHABILITATION AND NURSING, LLC
Address 3520 SOUTH HIGHLAND DRIVE
SALT LAKE CITY, UT 84106
Phone Number 8014847638
SSA County Code 170
County Name Salt Lake
Ownership Type Non profit - Other
Certified Beds 61
Certified Beds Residents 51
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name BEAVER VALLEY HOSPITAL
Date First Approved to Provide Medicare Medicaid Services 04/04/2016
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 2
Health Inspection Rating 3
Quality Measure Rating 1
Staffing Rating 3
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 0.08824
Reported LPN Staffing Hours per Resident per Day 1.72941
Reported RN Staffing Hours per Resident per Day 1.36569
Reported Licensed Staffing Hours per Resident per Day 3.0951
Reported Total Nurse Staffing Hours per Resident per Day 3.18334
Reported Physical Therapist Staffing Hours per Resident Per Day 0.02941
Expected CNA Staffing Hours per Resident per Day 2.42639
Expected LPN Staffing Hours per Resident per Day 0.67054
Expected RN Staffing Hours per Resident per Day 1.39203
Expected Total Nurse Staffing Hours per Resident per Day 4.48896
Adjusted CNA Staffing Hours per Resident per Day 0.08923
Adjusted LPN Staffing Hours per Resident per Day 2.14068
Adjusted RN Staffing Hours per Resident per Day 0.73306
Adjusted Total Nurse Staffing Hours per Resident per Day 2.85851
Cycle 1 Total Number of Health Deficiencies 3
Cycle 1 Number of Standard Health Deficiencies 3
Cycle 1 Health Deficiency Score 24
Cycle 1 Standard Survey Health Date 05/10/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 24
Cycle 2 Total Number of Health Deficiencies 12
Cycle 2 Number of Standard Health Deficiencies 12
Cycle 2 Health Deficiency Score 56
Cycle 2 Standard Health Survey Date 02/08/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 56
Total Weighted Health Survey Score 36.8
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Millcreek Rehabilitation and Nursing, LLC

Owner Name Role Association Date
BEAVER VALLEY HOSPITAL (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 11/01/2015
MYERS, WALTER (Individual) OPERATIONAL/MANAGERIAL CONTROL since 11/01/2015
SWAIN, JARED (Individual) OPERATIONAL/MANAGERIAL CONTROL since 11/01/2015

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