Hayes Residence - Saint Paul Nursing Home
General Information
UPDATEFederal Provider Number
24E508
Provider Name
HAYES RESIDENCE
Provider Address
1620 RANDOLPH AVENUE
SAINT PAUL, MN 55105
SAINT PAUL, MN 55105
Provider Phone Number
(651) 690-4458
Provider SSA County
610
Provider County Name
Ramsey
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
40
Number of Residents in Certified Beds
40
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1975-01-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
0.85750
Reported LPN Staffing Hours per Resident per Day
0.62125
Reported RN Staffing Hours per Resident per Day
0.29375
Reported Licensed Staffing Hours per Resident per Day
0.91500
Reported Total Nurse Staffing Hours per Resident per Day
1.77250
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.37921
Expected LPN Staffing Hours per Resident per Day
0.48272
Expected RN Staffing Hours per Resident per Day
0.61803
Expected Total Nurse Staffing Hours per Resident per Day
2.47996
Adjusted CNA Staffing Hours per Resident per Day
1.52555
Adjusted LPN Staffing Hours per Resident per Day
1.06819
Adjusted RN Staffing Hours per Resident per Day
0.35515
Adjusted Total Nurse Staffing Hours per Resident per Day
2.88101
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
2014-10-23
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
11
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2014-01-16
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
32
Cycle 2 Total Health Score
96
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2013-01-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
60.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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