Interfaith Care Center - Carlton Nursing Home
General Information
UPDATEFederal Provider Number
245024
Provider Name
INTERFAITH CARE CENTER
Provider Address
811 THIRD STREET
CARLTON, MN 55718
CARLTON, MN 55718
Provider Phone Number
(218) 384-4258
Provider SSA County
80
Provider County Name
Carlton
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
96
Number of Residents in Certified Beds
88
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
INTER-FAITH CARE CENTER
Date First Approved to Provide Medicare and Medicaid services
1969-01-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
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
2.44432
Reported LPN Staffing Hours per Resident per Day
0.60625
Reported RN Staffing Hours per Resident per Day
0.82443
Reported Licensed Staffing Hours per Resident per Day
1.43068
Reported Total Nurse Staffing Hours per Resident per Day
3.87500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.41304
Expected LPN Staffing Hours per Resident per Day
0.60162
Expected RN Staffing Hours per Resident per Day
0.95262
Expected Total Nurse Staffing Hours per Resident per Day
3.96727
Adjusted CNA Staffing Hours per Resident per Day
2.48551
Adjusted LPN Staffing Hours per Resident per Day
0.83639
Adjusted RN Staffing Hours per Resident per Day
0.64666
Adjusted Total Nurse Staffing Hours per Resident per Day
3.93715
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-06-27
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
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-06-13
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
24
Cycle 2 Total Health Score
72
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-08-02
Cycle 3 Number of Health Revisits
4
Cycle 3 Health Revisit Score
58
Cycle 3 Total Health Score
126
Total Weighted Health Survey Score
65.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
6
Total Amount of Fines in Dollars
5265
Number of Payment Denials
1
Total Number of Penalties
7
Location
Processing Date
2015-06-01
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