Fitzgerald Nh And Rehab - Eveleth Nursing Home
General Information
UPDATEFederal Provider Number
245125
Provider Name
FITZGERALD NH AND REHAB
Provider Address
227 MCKINLEY AVENUE
EVELETH, MN 55734
EVELETH, MN 55734
Provider Phone Number
(218) 744-7570
Provider SSA County
680
Provider County Name
St. Louis
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
24
Number of Residents in Certified Beds
22
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EHSP, INC.
Date First Approved to Provide Medicare and Medicaid services
1967-05-15
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
1.98864
Reported LPN Staffing Hours per Resident per Day
0.75227
Reported RN Staffing Hours per Resident per Day
0.62273
Reported Licensed Staffing Hours per Resident per Day
1.37500
Reported Total Nurse Staffing Hours per Resident per Day
3.36364
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01364
Expected CNA Staffing Hours per Resident per Day
2.33025
Expected LPN Staffing Hours per Resident per Day
0.58431
Expected RN Staffing Hours per Resident per Day
0.80729
Expected Total Nurse Staffing Hours per Resident per Day
3.72185
Adjusted CNA Staffing Hours per Resident per Day
2.09399
Adjusted LPN Staffing Hours per Resident per Day
1.06859
Adjusted RN Staffing Hours per Resident per Day
0.57638
Adjusted Total Nurse Staffing Hours per Resident per Day
3.64295
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
2014-12-11
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
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-10-30
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
26
Cycle 2 Total Health Score
78
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
24
Cycle 3 Standard Health Survey Date
2013-04-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
38.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
975
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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