Centracare Health - Monticello - Monticello Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
245511
Provider Name
CENTRACARE HEALTH - MONTICELLO
Provider Address
1013 HART BOULEVARD
MONTICELLO, MN 55362
MONTICELLO, MN 55362
Provider Phone Number
(763) 295-2945
Provider SSA County
850
Provider County Name
Wright
Provider Website
Provider Description
Ownership Type
Government - Hospital district
Number of Certified Beds
89
Number of Residents in Certified Beds
81
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
CENTRACARE HEALTH SYSTEM - NR, LLC
Date First Approved to Provide Medicare and Medicaid services
1988-01-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
2.64444
Reported LPN Staffing Hours per Resident per Day
0.68148
Reported RN Staffing Hours per Resident per Day
0.94444
Reported Licensed Staffing Hours per Resident per Day
1.62593
Reported Total Nurse Staffing Hours per Resident per Day
4.27036
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08827
Expected CNA Staffing Hours per Resident per Day
2.67838
Expected LPN Staffing Hours per Resident per Day
0.72398
Expected RN Staffing Hours per Resident per Day
1.14587
Expected Total Nurse Staffing Hours per Resident per Day
4.54823
Adjusted CNA Staffing Hours per Resident per Day
2.42260
Adjusted LPN Staffing Hours per Resident per Day
0.78128
Adjusted RN Staffing Hours per Resident per Day
0.61585
Adjusted Total Nurse Staffing Hours per Resident per Day
3.78463
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
20
Cycle 1 Standard Survey Health Date
2015-01-15
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
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-12-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
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
24
Cycle 3 Standard Health Survey Date
2012-10-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
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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