Birchwood Health Care Center - Forest Lake Nursing Home

General Information

UPDATE
Federal Provider Number
245200
Provider Name
BIRCHWOOD HEALTH CARE CENTER
Provider Address
604 - 1ST STREET NE
FOREST LAKE, MN 55025
Provider Phone Number
(651) 466-1022
Provider SSA County
810
Provider County Name
Washington
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
110
Number of Residents in Certified Beds
98
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SENIOR CARE FOREST LAKE, LLC
Date First Approved to Provide Medicare and Medicaid services
1974-12-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
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
2.30765
Reported LPN Staffing Hours per Resident per Day
0.75357
Reported RN Staffing Hours per Resident per Day
0.84082
Reported Licensed Staffing Hours per Resident per Day
1.59439
Reported Total Nurse Staffing Hours per Resident per Day
3.90204
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05459
Expected CNA Staffing Hours per Resident per Day
2.40279
Expected LPN Staffing Hours per Resident per Day
0.62595
Expected RN Staffing Hours per Resident per Day
0.94418
Expected Total Nurse Staffing Hours per Resident per Day
3.97292
Adjusted CNA Staffing Hours per Resident per Day
2.35655
Adjusted LPN Staffing Hours per Resident per Day
0.99922
Adjusted RN Staffing Hours per Resident per Day
0.66540
Adjusted Total Nurse Staffing Hours per Resident per Day
3.95898
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2014-05-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
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
2013-03-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
20.66700
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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