Augustana Hcc Of Apple Valley - Apple Valley Nursing Home
General Information
UPDATEFederal Provider Number
245264
Provider Name
AUGUSTANA HCC OF APPLE VALLEY
Provider Address
14650 GARRETT AVENUE
APPLE VALLEY, MN 55124
APPLE VALLEY, MN 55124
Provider Phone Number
(952) 236-2000
Provider SSA County
180
Provider County Name
Dakota
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
178
Number of Residents in Certified Beds
165
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AUGUSTANA HOME OF ST PAUL
Date First Approved to Provide Medicare and Medicaid services
1983-07-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
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
2.49394
Reported LPN Staffing Hours per Resident per Day
0.78939
Reported RN Staffing Hours per Resident per Day
0.86515
Reported Licensed Staffing Hours per Resident per Day
1.65455
Reported Total Nurse Staffing Hours per Resident per Day
4.14848
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13818
Expected CNA Staffing Hours per Resident per Day
2.52524
Expected LPN Staffing Hours per Resident per Day
0.67919
Expected RN Staffing Hours per Resident per Day
1.10355
Expected Total Nurse Staffing Hours per Resident per Day
4.30798
Adjusted CNA Staffing Hours per Resident per Day
2.42328
Adjusted LPN Staffing Hours per Resident per Day
0.96467
Adjusted RN Staffing Hours per Resident per Day
0.58578
Adjusted Total Nurse Staffing Hours per Resident per Day
3.88166
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-10-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-11-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2013-02-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
24.66700
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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