Centracare Health System - Melrose Pine Villa C C - Melrose Nursing Home
General Information
UPDATEFederal Provider Number
245396
Provider Name
CENTRACARE HEALTH SYSTEM - MELROSE PINE VILLA C C
Provider Address
525 WEST MAIN STREET
MELROSE, MN 56352
MELROSE, MN 56352
Provider Phone Number
(320) 256-4231
Provider SSA County
720
Provider County Name
Stearns
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
75
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
CENTRACARE HEALTH SYSTEM - MELROSE
Date First Approved to Provide Medicare and Medicaid services
1986-12-01
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
3
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
2.56867
Reported LPN Staffing Hours per Resident per Day
0.71667
Reported RN Staffing Hours per Resident per Day
0.50933
Reported Licensed Staffing Hours per Resident per Day
1.22600
Reported Total Nurse Staffing Hours per Resident per Day
3.79467
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17800
Expected CNA Staffing Hours per Resident per Day
2.56643
Expected LPN Staffing Hours per Resident per Day
0.53286
Expected RN Staffing Hours per Resident per Day
0.70658
Expected Total Nurse Staffing Hours per Resident per Day
3.80587
Adjusted CNA Staffing Hours per Resident per Day
2.45584
Adjusted LPN Staffing Hours per Resident per Day
1.11631
Adjusted RN Staffing Hours per Resident per Day
0.53861
Adjusted Total Nurse Staffing Hours per Resident per Day
4.01904
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-05-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
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
20
Cycle 2 Standard Health Survey Date
2013-03-28
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
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-02-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
26.66700
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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