Johnson Memorial Hosp & Home - Dawson Nursing Home
General Information
UPDATEFederal Provider Number
245485
Provider Name
JOHNSON MEMORIAL HOSP & HOME
Provider Address
1282 WALNUT STREET
DAWSON, MN 56232
DAWSON, MN 56232
Provider Phone Number
(320) 769-2350
Provider SSA County
360
Provider County Name
Lac Qui Parle
Provider Website
Provider Description
Ownership Type
Government - Hospital district
Number of Certified Beds
56
Number of Residents in Certified Beds
52
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
JOHNSON MEMORIAL HEALTH SERVICES
Date First Approved to Provide Medicare and Medicaid services
1987-06-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
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
2.88558
Reported LPN Staffing Hours per Resident per Day
0.70481
Reported RN Staffing Hours per Resident per Day
0.99038
Reported Licensed Staffing Hours per Resident per Day
1.69519
Reported Total Nurse Staffing Hours per Resident per Day
4.58077
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00096
Expected CNA Staffing Hours per Resident per Day
2.26901
Expected LPN Staffing Hours per Resident per Day
0.55532
Expected RN Staffing Hours per Resident per Day
0.69279
Expected Total Nurse Staffing Hours per Resident per Day
3.51711
Adjusted CNA Staffing Hours per Resident per Day
3.12046
Adjusted LPN Staffing Hours per Resident per Day
1.05344
Adjusted RN Staffing Hours per Resident per Day
1.06816
Adjusted Total Nurse Staffing Hours per Resident per Day
5.24994
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-08-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
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
4
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-05-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
15.33300
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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