Courage Kenny Rehabilitation Institute's Trp - Golden Valley Nursing Home
General Information
UPDATEFederal Provider Number
245519
Provider Name
COURAGE KENNY REHABILITATION INSTITUTE'S TRP
Provider Address
3915 GOLDEN VALLEY ROAD
GOLDEN VALLEY, MN 55422
GOLDEN VALLEY, MN 55422
Provider Phone Number
(763) 520-0327
Provider SSA County
260
Provider County Name
Hennepin
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
44
Number of Residents in Certified Beds
36
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ALLINA HEALTH SYSTEM
Date First Approved to Provide Medicare and Medicaid services
1988-02-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
4.19444
Reported LPN Staffing Hours per Resident per Day
0.55278
Reported RN Staffing Hours per Resident per Day
2.05278
Reported Licensed Staffing Hours per Resident per Day
2.60556
Reported Total Nurse Staffing Hours per Resident per Day
6.80000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.91667
Expected CNA Staffing Hours per Resident per Day
2.42799
Expected LPN Staffing Hours per Resident per Day
0.73190
Expected RN Staffing Hours per Resident per Day
1.52345
Expected Total Nurse Staffing Hours per Resident per Day
4.68335
Adjusted CNA Staffing Hours per Resident per Day
4.23885
Adjusted LPN Staffing Hours per Resident per Day
0.62687
Adjusted RN Staffing Hours per Resident per Day
1.00682
Adjusted Total Nurse Staffing Hours per Resident per Day
5.85268
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-10-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
14
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2013-10-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
80
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-11-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
35.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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