Kenyon Sunset Home - Kenyon Nursing Home
General Information
UPDATEFederal Provider Number
245379
Provider Name
KENYON SUNSET HOME
Provider Address
127 GUNDERSON BOULEVARD
KENYON, MN 55946
KENYON, MN 55946
Provider Phone Number
5077896134
Provider SSA County
240
Provider County Name
Goodhue
Ownership Type
Non profit - Church related
Number of Certified Beds
30
Number of Residents in Certified Beds
28
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
KENYON SUNSET HOME
Date First Approved to Provide Medicare and Medicaid services
1986-12-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
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
2.32500
Reported LPN Staffing Hours per Resident per Day
0.80893
Reported RN Staffing Hours per Resident per Day
0.76786
Reported Licensed Staffing Hours per Resident per Day
1.57679
Reported Total Nurse Staffing Hours per Resident per Day
3.90179
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04107
Expected CNA Staffing Hours per Resident per Day
2.29664
Expected LPN Staffing Hours per Resident per Day
0.59014
Expected RN Staffing Hours per Resident per Day
0.99060
Expected Total Nurse Staffing Hours per Resident per Day
3.87738
Adjusted CNA Staffing Hours per Resident per Day
2.48400
Adjusted LPN Staffing Hours per Resident per Day
1.13771
Adjusted RN Staffing Hours per Resident per Day
0.57919
Adjusted Total Nurse Staffing Hours per Resident per Day
4.05627
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2014-12-19
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
36
Cycle 1 Total Health Score
108
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
139
Cycle 2 Standard Health Survey Date
2013-11-01
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
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2013-01-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
110.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
18038
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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