Andrew Residence - Minneapolis Nursing Home
General Information
UPDATEFederal Provider Number
240000000000000000000000000000
Provider Name
ANDREW RESIDENCE
Provider Address
1215 SOUTH 9TH STREET
MINNEAPOLIS, MN 55404
MINNEAPOLIS, MN 55404
Provider Phone Number
6123330111
Provider SSA County
260
Provider County Name
Hennepin
Ownership Type
For profit - Individual
Number of Certified Beds
212
Number of Residents in Certified Beds
209
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1974-03-31
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
5
QM Rating Footnote
Staffing Rating
3
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
0.89785
Reported LPN Staffing Hours per Resident per Day
0.14856
Reported RN Staffing Hours per Resident per Day
0.57105
Reported Licensed Staffing Hours per Resident per Day
0.71962
Reported Total Nurse Staffing Hours per Resident per Day
1.61746
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.28177
Expected LPN Staffing Hours per Resident per Day
0.44664
Expected RN Staffing Hours per Resident per Day
0.59821
Expected Total Nurse Staffing Hours per Resident per Day
2.32661
Adjusted CNA Staffing Hours per Resident per Day
1.71876
Adjusted LPN Staffing Hours per Resident per Day
0.27607
Adjusted RN Staffing Hours per Resident per Day
0.71328
Adjusted Total Nurse Staffing Hours per Resident per Day
2.80228
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
4
Cycle 1 Standard Survey Health Date
2015-04-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
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
16
Cycle 2 Standard Health Survey Date
2014-05-20
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
8
Cycle 3 Standard Health Survey Date
2013-06-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
8.66700
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
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