Minnesota Nursing Homes >> Pine Island Nursing Homes >> Pine Haven Care Center Inc

Pine Haven Care Center Inc - Pine Island Nursing Home

General Information

UPDATE
Federal Provider Number
245359
Provider Name
PINE HAVEN CARE CENTER INC
Provider Address
210 NORTHWEST 3RD STREET
PINE ISLAND, MN 55963
Provider Phone Number
5073568304
Provider SSA County
240
Provider County Name
Goodhue
Ownership Type
Non profit - Corporation
Number of Certified Beds
66
Number of Residents in Certified Beds
56
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PINE HAVEN CARE CENTER INC
Date First Approved to Provide Medicare and Medicaid services
1986-11-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
1.83214
Reported LPN Staffing Hours per Resident per Day
0.60714
Reported RN Staffing Hours per Resident per Day
0.82500
Reported Licensed Staffing Hours per Resident per Day
1.43214
Reported Total Nurse Staffing Hours per Resident per Day
3.26428
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10089
Expected CNA Staffing Hours per Resident per Day
2.46497
Expected LPN Staffing Hours per Resident per Day
0.60097
Expected RN Staffing Hours per Resident per Day
0.93529
Expected Total Nurse Staffing Hours per Resident per Day
4.00123
Adjusted CNA Staffing Hours per Resident per Day
1.82376
Adjusted LPN Staffing Hours per Resident per Day
0.83853
Adjusted RN Staffing Hours per Resident per Day
0.65909
Adjusted Total Nurse Staffing Hours per Resident per Day
3.28849
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-09-25
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
18
Cycle 1 Total Health Score
54
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-06-06
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-04-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
50.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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