Camilia Rose Care Center Llc - Coon Rapids Nursing Home

General Information

UPDATE
Federal Provider Number
245353
Provider Name
CAMILIA ROSE CARE CENTER LLC
Provider Address
11800 XEON BOULEVARD
COON RAPIDS, MN 55448
Provider Phone Number
7637558400
Provider SSA County
10
Provider County Name
Anoka
Ownership Type
For profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
76
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CAMILIA ROSE COMPANY INC
Date First Approved to Provide Medicare and Medicaid services
1986-10-13
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
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
3.03618
Reported LPN Staffing Hours per Resident per Day
0.74211
Reported RN Staffing Hours per Resident per Day
0.77039
Reported Licensed Staffing Hours per Resident per Day
1.51250
Reported Total Nurse Staffing Hours per Resident per Day
4.54868
Reported Physical Therapist Staffing Hours per Resident Per Day
0.18487
Expected CNA Staffing Hours per Resident per Day
2.57000
Expected LPN Staffing Hours per Resident per Day
0.64938
Expected RN Staffing Hours per Resident per Day
1.12802
Expected Total Nurse Staffing Hours per Resident per Day
4.34741
Adjusted CNA Staffing Hours per Resident per Day
2.89878
Adjusted LPN Staffing Hours per Resident per Day
0.94852
Adjusted RN Staffing Hours per Resident per Day
0.51030
Adjusted Total Nurse Staffing Hours per Resident per Day
4.21752
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
15
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
124
Cycle 2 Standard Health Survey Date
2014-03-13
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
6
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2013-04-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
78.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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