Friendship Village Of Bloomington - Bloomington Nursing Home
General Information
UPDATEFederal Provider Number
245229
Provider Name
FRIENDSHIP VILLAGE OF BLOOMINGTON
Provider Address
8100 HIGHWOOD DRIVE
BLOOMINGTON, MN 55438
BLOOMINGTON, MN 55438
Provider Phone Number
9528317500
Provider SSA County
260
Provider County Name
Hennepin
Ownership Type
Non profit - Corporation
Number of Certified Beds
66
Number of Residents in Certified Beds
57
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
LIFESPACE COMMUNITIES INC
Date First Approved to Provide Medicare and Medicaid services
1980-01-29
Continuing Care Retirement Community
Y
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
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.66491
Reported LPN Staffing Hours per Resident per Day
0.95877
Reported RN Staffing Hours per Resident per Day
0.93158
Reported Licensed Staffing Hours per Resident per Day
1.89035
Reported Total Nurse Staffing Hours per Resident per Day
4.55526
Reported Physical Therapist Staffing Hours per Resident Per Day
0.24035
Expected CNA Staffing Hours per Resident per Day
2.57498
Expected LPN Staffing Hours per Resident per Day
0.58730
Expected RN Staffing Hours per Resident per Day
0.97080
Expected Total Nurse Staffing Hours per Resident per Day
4.13308
Adjusted CNA Staffing Hours per Resident per Day
2.53939
Adjusted LPN Staffing Hours per Resident per Day
1.35497
Adjusted RN Staffing Hours per Resident per Day
0.71701
Adjusted Total Nurse Staffing Hours per Resident per Day
4.44264
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-05-22
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
28
Cycle 2 Standard Health Survey Date
2013-04-11
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
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
2012-07-19
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
9.33300
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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