Cornerstone Villa - Buhl Nursing Home
General Information
UPDATEFederal Provider Number
245612
Provider Name
CORNERSTONE VILLA
Provider Address
1000 FOREST STREET PO BOX 724
BUHL, MN 55713
BUHL, MN 55713
Provider Phone Number
(218) 258-3253
Provider SSA County
680
Provider County Name
St. Louis
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
44
Number of Residents in Certified Beds
38
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FOREST HEALTH SERVICES INC
Date First Approved to Provide Medicare and Medicaid services
2004-07-16
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
5
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
2.71579
Reported LPN Staffing Hours per Resident per Day
0.89474
Reported RN Staffing Hours per Resident per Day
0.66316
Reported Licensed Staffing Hours per Resident per Day
1.55789
Reported Total Nurse Staffing Hours per Resident per Day
4.27369
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04342
Expected CNA Staffing Hours per Resident per Day
2.63017
Expected LPN Staffing Hours per Resident per Day
0.73539
Expected RN Staffing Hours per Resident per Day
1.27433
Expected Total Nurse Staffing Hours per Resident per Day
4.63990
Adjusted CNA Staffing Hours per Resident per Day
2.53358
Adjusted LPN Staffing Hours per Resident per Day
1.00985
Adjusted RN Staffing Hours per Resident per Day
0.38884
Adjusted Total Nurse Staffing Hours per Resident per Day
3.71276
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
16
Cycle 1 Standard Survey Health Date
2014-09-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-08-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
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
52
Cycle 3 Standard Health Survey Date
2012-06-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
34.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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