Crest View Lutheran Home - Columbia Heights Nursing Home
General Information
UPDATEFederal Provider Number
245018
Provider Name
CREST VIEW LUTHERAN HOME
Provider Address
4444 RESERVOIR BOULEVARD NORTHEAST
COLUMBIA HEIGHTS, MN 55421
COLUMBIA HEIGHTS, MN 55421
Provider Phone Number
7637821611
Provider SSA County
10
Provider County Name
Anoka
Ownership Type
Non profit - Corporation
Number of Certified Beds
122
Number of Residents in Certified Beds
115
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CREST VIEW CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
2
Health Inspection Rating Footnote
QM Rating
3
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
2.41739
Reported LPN Staffing Hours per Resident per Day
0.69565
Reported RN Staffing Hours per Resident per Day
0.50652
Reported Licensed Staffing Hours per Resident per Day
1.20217
Reported Total Nurse Staffing Hours per Resident per Day
3.61956
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04826
Expected CNA Staffing Hours per Resident per Day
2.34282
Expected LPN Staffing Hours per Resident per Day
0.60244
Expected RN Staffing Hours per Resident per Day
0.95711
Expected Total Nurse Staffing Hours per Resident per Day
3.90237
Adjusted CNA Staffing Hours per Resident per Day
2.53180
Adjusted LPN Staffing Hours per Resident per Day
0.95842
Adjusted RN Staffing Hours per Resident per Day
0.39543
Adjusted Total Nurse Staffing Hours per Resident per Day
3.73877
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
64
Cycle 1 Standard Survey Health Date
2014-08-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
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
0
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2013-03-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
52.66700
Number of Facility Reported Incidents
1
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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