Hendricks Community Hospital - Hendricks Nursing Home
General Information
UPDATEFederal Provider Number
245467
Provider Name
HENDRICKS COMMUNITY HOSPITAL
Provider Address
503 E LINCOLN STREET
HENDRICKS, MN 56136
HENDRICKS, MN 56136
Provider Phone Number
(507) 275-3134
Provider SSA County
400
Provider County Name
Lincoln
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
58
Number of Residents in Certified Beds
57
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
HENDRICKS COMMUNITY HOSPITAL ASSN & RETIREMENT HOME
Date First Approved to Provide Medicare and Medicaid services
1987-04-01
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
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
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.00877
Reported LPN Staffing Hours per Resident per Day
0.31579
Reported RN Staffing Hours per Resident per Day
0.70526
Reported Licensed Staffing Hours per Resident per Day
1.02105
Reported Total Nurse Staffing Hours per Resident per Day
3.02982
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00526
Expected CNA Staffing Hours per Resident per Day
2.35909
Expected LPN Staffing Hours per Resident per Day
0.53944
Expected RN Staffing Hours per Resident per Day
0.73225
Expected Total Nurse Staffing Hours per Resident per Day
3.63078
Adjusted CNA Staffing Hours per Resident per Day
2.08933
Adjusted LPN Staffing Hours per Resident per Day
0.48588
Adjusted RN Staffing Hours per Resident per Day
0.71966
Adjusted Total Nurse Staffing Hours per Resident per Day
3.36371
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
36
Cycle 1 Standard Survey Health Date
2014-06-05
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
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
48
Cycle 2 Standard Health Survey Date
2013-07-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
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
20
Cycle 3 Standard Health Survey Date
2012-09-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
37.33300
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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