Elim Home - Watertown - Watertown Nursing Home
General Information
UPDATEFederal Provider Number
245437
Provider Name
ELIM HOME - WATERTOWN
Provider Address
409 JEFFERSON AVENUE SOUTHWEST, BOX 638
WATERTOWN, MN 55388
WATERTOWN, MN 55388
Provider Phone Number
9529552691
Provider SSA County
90
Provider County Name
Carver
Ownership Type
Non profit - Church related
Number of Certified Beds
51
Number of Residents in Certified Beds
51
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ELIM HOMES, INC.
Date First Approved to Provide Medicare and Medicaid services
1987-03-01
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
5
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.72353
Reported LPN Staffing Hours per Resident per Day
0.70588
Reported RN Staffing Hours per Resident per Day
0.80392
Reported Licensed Staffing Hours per Resident per Day
1.50980
Reported Total Nurse Staffing Hours per Resident per Day
4.23333
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00686
Expected CNA Staffing Hours per Resident per Day
2.77568
Expected LPN Staffing Hours per Resident per Day
0.61263
Expected RN Staffing Hours per Resident per Day
0.84681
Expected Total Nurse Staffing Hours per Resident per Day
4.23512
Adjusted CNA Staffing Hours per Resident per Day
2.40760
Adjusted LPN Staffing Hours per Resident per Day
0.95634
Adjusted RN Staffing Hours per Resident per Day
0.70935
Adjusted Total Nurse Staffing Hours per Resident per Day
4.02920
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-07-31
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
0
Cycle 2 Standard Health Survey Date
2013-09-12
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-06-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
10.66700
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
Nursiong Homes Nearby
Good Samaritan Society - Waconia And Westview Acre
333 Fifth Street West |
WACONIA MN 55387 | 8.7 miles away
Auburn Home In Waconia
594 Cherry Drive |
WACONIA MN 55387 | 8.7 miles away
Auburn Manor
501 Oak Street |
CHASKA MN 55318 | 17.1 miles away
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