Fair Meadow Nursing Home - Fertile Nursing Home
General Information
UPDATEFederal Provider Number
245545
Provider Name
FAIR MEADOW NURSING HOME
Provider Address
BOX 8 300 GARFIELD AVENUE SOUTHEAST
FERTILE, MN 56540
FERTILE, MN 56540
Provider Phone Number
(218) 945-6194
Provider SSA County
590
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
Government - City
Number of Certified Beds
50
Number of Residents in Certified Beds
45
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
VILLAGE OF FERTILE
Date First Approved to Provide Medicare and Medicaid services
1991-02-01
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
4
Health Inspection Rating Footnote
QM Rating
4
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
2.82000
Reported LPN Staffing Hours per Resident per Day
1.01667
Reported RN Staffing Hours per Resident per Day
0.54889
Reported Licensed Staffing Hours per Resident per Day
1.56556
Reported Total Nurse Staffing Hours per Resident per Day
4.38556
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01111
Expected CNA Staffing Hours per Resident per Day
2.44763
Expected LPN Staffing Hours per Resident per Day
0.59704
Expected RN Staffing Hours per Resident per Day
0.78537
Expected Total Nurse Staffing Hours per Resident per Day
3.83004
Adjusted CNA Staffing Hours per Resident per Day
2.82699
Adjusted LPN Staffing Hours per Resident per Day
1.41337
Adjusted RN Staffing Hours per Resident per Day
0.52221
Adjusted Total Nurse Staffing Hours per Resident per Day
4.61556
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-04-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-07-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-09-06
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
24.00000
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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