Cook Co Northshore Hosp & C&nc - Grand Marais Nursing Home
General Information
UPDATEFederal Provider Number
245384
Provider Name
COOK CO NORTHSHORE HOSP & C&NC
Provider Address
515 - 5TH AVENUE WEST
GRAND MARAIS, MN 55604
GRAND MARAIS, MN 55604
Provider Phone Number
(218) 387-3040
Provider SSA County
150
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
Government - Hospital district
Number of Certified Beds
37
Number of Residents in Certified Beds
34
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
COOK COUNTY HOSPITAL DISTRICT
Date First Approved to Provide Medicare and Medicaid services
1987-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
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
5
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
3.49706
Reported LPN Staffing Hours per Resident per Day
0.93235
Reported RN Staffing Hours per Resident per Day
0.55735
Reported Licensed Staffing Hours per Resident per Day
1.48971
Reported Total Nurse Staffing Hours per Resident per Day
4.98676
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16912
Expected CNA Staffing Hours per Resident per Day
2.31935
Expected LPN Staffing Hours per Resident per Day
0.61716
Expected RN Staffing Hours per Resident per Day
0.87947
Expected Total Nurse Staffing Hours per Resident per Day
3.81598
Adjusted CNA Staffing Hours per Resident per Day
3.69964
Adjusted LPN Staffing Hours per Resident per Day
1.25388
Adjusted RN Staffing Hours per Resident per Day
0.47352
Adjusted Total Nurse Staffing Hours per Resident per Day
5.26761
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2014-08-21
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
44
Cycle 1 Total Health Score
132
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
24
Cycle 2 Standard Health Survey Date
2013-09-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-07-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
76.66700
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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