Heritage Manor - Chisholm Nursing Home
General Information
UPDATEFederal Provider Number
245245
Provider Name
HERITAGE MANOR
Provider Address
321 NORTHEAST SIXTH STREET
CHISHOLM, MN 55719
CHISHOLM, MN 55719
Provider Phone Number
2182545765
Provider SSA County
680
Provider County Name
St. Louis
Ownership Type
Non profit - Church related
Number of Certified Beds
78
Number of Residents in Certified Beds
71
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CHISHOLM HEALTH CENTER
Date First Approved to Provide Medicare and Medicaid services
1982-09-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.56831
Reported LPN Staffing Hours per Resident per Day
0.71620
Reported RN Staffing Hours per Resident per Day
0.85211
Reported Licensed Staffing Hours per Resident per Day
1.56831
Reported Total Nurse Staffing Hours per Resident per Day
4.13662
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08239
Expected CNA Staffing Hours per Resident per Day
2.38394
Expected LPN Staffing Hours per Resident per Day
0.60467
Expected RN Staffing Hours per Resident per Day
0.93054
Expected Total Nurse Staffing Hours per Resident per Day
3.91915
Adjusted CNA Staffing Hours per Resident per Day
2.64347
Adjusted LPN Staffing Hours per Resident per Day
0.98309
Adjusted RN Staffing Hours per Resident per Day
0.68423
Adjusted Total Nurse Staffing Hours per Resident per Day
4.25457
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-10-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
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
56
Cycle 2 Standard Health Survey Date
2013-11-07
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
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2013-01-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
40.66700
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
Nursiong Homes Nearby
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St Michaels Health & Rehab Center
1201 8th Street South |
VIRGINIA MN 55792 | 15 miles away
Essentia Health Virginia Care Cent
901 9th Street North |
VIRGINIA MN 55792 | 15.2 miles away
St Raphaels Health & Rehab Center
601 Grant Avenue |
EVELETH MN 55734 | 15.6 miles away
Fitzgerald Nh And Rehab
227 Mckinley Avenue |
EVELETH MN 55734 | 15.9 miles away
Cook Community Hospital C&nc
10 Southeast Fifth Street |
COOK MN 55723 | 26.4 miles away
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