Divine Providence Health Center - Ivanhoe Nursing Home
General Information
UPDATEFederal Provider Number
245327
Provider Name
DIVINE PROVIDENCE HEALTH CENTER
Provider Address
312 EAST GEORGE ST PO BOX 136
IVANHOE, MN 56142
IVANHOE, MN 56142
Provider Phone Number
(507) 694-1414
Provider SSA County
400
Provider County Name
Lincoln
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
25
Number of Residents in Certified Beds
23
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DIVINE PROVIDENCE HEATLH CENTER INC.
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
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
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
2.11304
Reported LPN Staffing Hours per Resident per Day
0.66304
Reported RN Staffing Hours per Resident per Day
0.78043
Reported Licensed Staffing Hours per Resident per Day
1.44348
Reported Total Nurse Staffing Hours per Resident per Day
3.55651
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01522
Expected CNA Staffing Hours per Resident per Day
2.18997
Expected LPN Staffing Hours per Resident per Day
0.53740
Expected RN Staffing Hours per Resident per Day
0.83913
Expected Total Nurse Staffing Hours per Resident per Day
3.56650
Adjusted CNA Staffing Hours per Resident per Day
2.36751
Adjusted LPN Staffing Hours per Resident per Day
1.02405
Adjusted RN Staffing Hours per Resident per Day
0.69493
Adjusted Total Nurse Staffing Hours per Resident per Day
4.01961
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-06-25
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
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
2013-05-21
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-04-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
17.33300
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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