Country Manor Health & Rehab Ctr - Sartell Nursing Home
General Information
UPDATEFederal Provider Number
245330
Provider Name
COUNTRY MANOR HEALTH & REHAB CTR
Provider Address
520 FIRST STREET NORTHEAST
SARTELL, MN 56377
SARTELL, MN 56377
Provider Phone Number
(320) 253-1920
Provider SSA County
720
Provider County Name
Stearns
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
165
Number of Residents in Certified Beds
159
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTRY MANOR CAMPUS LLC
Date First Approved to Provide Medicare and Medicaid services
1986-07-01
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
2.83333
Reported LPN Staffing Hours per Resident per Day
1.12987
Reported RN Staffing Hours per Resident per Day
0.81352
Reported Licensed Staffing Hours per Resident per Day
1.94340
Reported Total Nurse Staffing Hours per Resident per Day
4.77672
Reported Physical Therapist Staffing Hours per Resident Per Day
0.20849
Expected CNA Staffing Hours per Resident per Day
2.55599
Expected LPN Staffing Hours per Resident per Day
0.62062
Expected RN Staffing Hours per Resident per Day
1.00454
Expected Total Nurse Staffing Hours per Resident per Day
4.18115
Adjusted CNA Staffing Hours per Resident per Day
2.71994
Adjusted LPN Staffing Hours per Resident per Day
1.51107
Adjusted RN Staffing Hours per Resident per Day
0.60511
Adjusted Total Nurse Staffing Hours per Resident per Day
4.60507
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-03-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2014-01-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-03-28
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
12.00000
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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