Broen Memorial Home - Fergus Falls Nursing Home
General Information
UPDATEFederal Provider Number
245453
Provider Name
BROEN MEMORIAL HOME
Provider Address
824 SOUTH SHERIDAN
FERGUS FALLS, MN 56537
FERGUS FALLS, MN 56537
Provider Phone Number
2189987300
Provider SSA County
550
Provider County Name
Otter Tail
Ownership Type
Non profit - Corporation
Number of Certified Beds
107
Number of Residents in Certified Beds
92
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LUTHERAN BRETHREN RETIREMENT SERVICES INC
Date First Approved to Provide Medicare and Medicaid services
1987-04-01
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
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.51793
Reported LPN Staffing Hours per Resident per Day
0.86033
Reported RN Staffing Hours per Resident per Day
0.56902
Reported Licensed Staffing Hours per Resident per Day
1.42935
Reported Total Nurse Staffing Hours per Resident per Day
3.94728
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05217
Expected CNA Staffing Hours per Resident per Day
2.43091
Expected LPN Staffing Hours per Resident per Day
0.62252
Expected RN Staffing Hours per Resident per Day
0.99575
Expected Total Nurse Staffing Hours per Resident per Day
4.04918
Adjusted CNA Staffing Hours per Resident per Day
2.54154
Adjusted LPN Staffing Hours per Resident per Day
1.14708
Adjusted RN Staffing Hours per Resident per Day
0.42699
Adjusted Total Nurse Staffing Hours per Resident per Day
3.92946
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
28
Cycle 1 Standard Survey Health Date
2014-04-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-05-09
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
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-08-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
37.33300
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
Pioneer Care Center
1131 South Mabelle Avenue |
FERGUS FALLS MN 56537 | 0.3 mile away
Good Samaritan Society - Battle Lake
105 Glenhaven Drive |
BATTLE LAKE MN 56515 | 16.7 miles away
Pelican Valley Health Center
211 East Mill Avenue |
PELICAN RAPIDS MN 56572 | 20.3 miles away
Golden Livingcenter - Henning
907 Marshall Avenue, Po Box 57 |
HENNING MN 56551 | 29.7 miles away
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