Grand Village - Grand Rapids Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
245368
Provider Name
GRAND VILLAGE
Provider Address
923 HALE LAKE POINTE
GRAND RAPIDS, MN 55744
GRAND RAPIDS, MN 55744
Provider Phone Number
(218) 326-0543
Provider SSA County
300
Provider County Name
Itasca
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
119
Number of Residents in Certified Beds
100
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ITASCA NURSING HOME
Date First Approved to Provide Medicare and Medicaid services
1986-11-01
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
1
Health Inspection Rating Footnote
QM Rating
2
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
3.06850
Reported LPN Staffing Hours per Resident per Day
1.45200
Reported RN Staffing Hours per Resident per Day
1.00800
Reported Licensed Staffing Hours per Resident per Day
2.46000
Reported Total Nurse Staffing Hours per Resident per Day
5.52850
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11700
Expected CNA Staffing Hours per Resident per Day
2.53104
Expected LPN Staffing Hours per Resident per Day
0.65420
Expected RN Staffing Hours per Resident per Day
1.02045
Expected Total Nurse Staffing Hours per Resident per Day
4.20569
Adjusted CNA Staffing Hours per Resident per Day
2.97473
Adjusted LPN Staffing Hours per Resident per Day
1.84219
Adjusted RN Staffing Hours per Resident per Day
0.73809
Adjusted Total Nurse Staffing Hours per Resident per Day
5.29874
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2014-10-31
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
46
Cycle 1 Total Health Score
138
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-11-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2013-02-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
83.66700
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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