Essentia Health Fosston - Fosston Nursing Home
General Information
UPDATEFederal Provider Number
245512
Provider Name
ESSENTIA HEALTH FOSSTON
Provider Address
900 HILLIGOSS BOULEVARD SOUTHEAST
FOSSTON, MN 56542
FOSSTON, MN 56542
Provider Phone Number
(218) 435-1133
Provider SSA County
590
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
44
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
FIRST CARE MEDICAL SERVICES
Date First Approved to Provide Medicare and Medicaid services
1988-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.57159
Reported LPN Staffing Hours per Resident per Day
1.09091
Reported RN Staffing Hours per Resident per Day
0.39545
Reported Licensed Staffing Hours per Resident per Day
1.48636
Reported Total Nurse Staffing Hours per Resident per Day
4.05795
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00341
Expected CNA Staffing Hours per Resident per Day
2.67805
Expected LPN Staffing Hours per Resident per Day
0.63687
Expected RN Staffing Hours per Resident per Day
0.88285
Expected Total Nurse Staffing Hours per Resident per Day
4.19777
Adjusted CNA Staffing Hours per Resident per Day
2.35616
Adjusted LPN Staffing Hours per Resident per Day
1.42172
Adjusted RN Staffing Hours per Resident per Day
0.33469
Adjusted Total Nurse Staffing Hours per Resident per Day
3.89664
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-09-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
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
100
Cycle 2 Standard Health Survey Date
2013-09-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
100
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
4
Cycle 3 Standard Health Survey Date
2012-07-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
50.00000
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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