Brookefield Park - St Paul Nursing Home
General Information
UPDATEFederal Provider Number
285226
Provider Name
BROOKEFIELD PARK
Provider Address
1405 HERITAGE DRIVE
ST PAUL, NE 68873
ST PAUL, NE 68873
Provider Phone Number
3087545486
Provider SSA County
460
Provider County Name
Howard
Ownership Type
For profit - Corporation
Number of Certified Beds
70
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HERITAGE OF ST PAUL, INC
Date First Approved to Provide Medicare and Medicaid services
1998-03-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.52209
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
1.11628
Reported Licensed Staffing Hours per Resident per Day
1.11628
Reported Total Nurse Staffing Hours per Resident per Day
4.63837
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02442
Expected CNA Staffing Hours per Resident per Day
2.56673
Expected LPN Staffing Hours per Resident per Day
0.60484
Expected RN Staffing Hours per Resident per Day
0.90045
Expected Total Nurse Staffing Hours per Resident per Day
4.07202
Adjusted CNA Staffing Hours per Resident per Day
3.36699
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.92630
Adjusted Total Nurse Staffing Hours per Resident per Day
4.59153
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-02-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2012-12-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2011-08-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
13.33300
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
Location
Processing Date
2015-06-01
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