Elliot Care Home Inc - Minneapolis Nursing Home
General Information
UPDATEFederal Provider Number
240000000000000000000000000000
Provider Name
ELLIOT CARE HOME INC
Provider Address
1500 ELLIOT AVENUE SOUTH
MINNEAPOLIS, MN 55404
MINNEAPOLIS, MN 55404
Provider Phone Number
6123392291
Provider SSA County
260
Provider County Name
Hennepin
Ownership Type
For profit - Corporation
Number of Certified Beds
15
Number of Residents in Certified Beds
14
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1976-04-01
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
5
QM Rating Footnote
Staffing Rating
2
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
0.93929
Reported LPN Staffing Hours per Resident per Day
0.58214
Reported RN Staffing Hours per Resident per Day
0.42857
Reported Licensed Staffing Hours per Resident per Day
1.01071
Reported Total Nurse Staffing Hours per Resident per Day
1.95000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.37218
Expected LPN Staffing Hours per Resident per Day
0.44051
Expected RN Staffing Hours per Resident per Day
0.60603
Expected Total Nurse Staffing Hours per Resident per Day
2.41872
Adjusted CNA Staffing Hours per Resident per Day
1.67962
Adjusted LPN Staffing Hours per Resident per Day
1.09685
Adjusted RN Staffing Hours per Resident per Day
0.52841
Adjusted Total Nurse Staffing Hours per Resident per Day
3.24976
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-02-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
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
16
Cycle 2 Standard Health Survey Date
2014-01-23
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
100
Cycle 3 Standard Health Survey Date
2012-11-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
100
Total Weighted Health Survey Score
32.00000
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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