Folkestone - Wayzata Nursing Home
General Information
UPDATEFederal Provider Number
245621
Provider Name
FOLKESTONE
Provider Address
100 PROMENADE AVENUE
WAYZATA, MN 55391
WAYZATA, MN 55391
Provider Phone Number
(952) 249-2500
Provider SSA County
260
Provider County Name
Hennepin
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
30
Number of Residents in Certified Beds
28
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
WAYZATA BAY SENIOR HOUSING INC
Date First Approved to Provide Medicare and Medicaid services
2014-06-06
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
0
Staffing Rating Footnote
Data Not Available
RN Staffing Rating
0
RN Staffing Rating Footnote
Data Not Available
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.99643
Reported LPN Staffing Hours per Resident per Day
0.18393
Reported RN Staffing Hours per Resident per Day
1.02679
Reported Licensed Staffing Hours per Resident per Day
1.21071
Reported Total Nurse Staffing Hours per Resident per Day
4.20715
Reported Physical Therapist Staffing Hours per Resident Per Day
0.24286
Expected CNA Staffing Hours per Resident per Day
0.00000
Expected LPN Staffing Hours per Resident per Day
0.00000
Expected RN Staffing Hours per Resident per Day
0.00000
Expected Total Nurse Staffing Hours per Resident per Day
0.00000
Adjusted CNA Staffing Hours per Resident per Day
0.00000
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.00000
Adjusted Total Nurse Staffing Hours per Resident per Day
0.00000
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-03-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2014-05-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
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
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
12.80000
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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