Kittson Memorial Healthcare Center - Hallock Nursing Home
General Information
UPDATEFederal Provider Number
245247
Provider Name
KITTSON MEMORIAL HEALTHCARE CENTER
Provider Address
1010 SOUTH BIRCH
HALLOCK, MN 56728
HALLOCK, MN 56728
Provider Phone Number
2188433612
Provider SSA County
340
Provider County Name
Kittson
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
56
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
KITTSON MEMORIAL HOSPITAL ASSOCIATION
Date First Approved to Provide Medicare and Medicaid services
1982-07-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
2.26161
Reported LPN Staffing Hours per Resident per Day
0.93482
Reported RN Staffing Hours per Resident per Day
0.68393
Reported Licensed Staffing Hours per Resident per Day
1.61875
Reported Total Nurse Staffing Hours per Resident per Day
3.88036
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.28763
Expected LPN Staffing Hours per Resident per Day
0.51245
Expected RN Staffing Hours per Resident per Day
0.72998
Expected Total Nurse Staffing Hours per Resident per Day
3.53006
Adjusted CNA Staffing Hours per Resident per Day
2.42579
Adjusted LPN Staffing Hours per Resident per Day
1.51410
Adjusted RN Staffing Hours per Resident per Day
0.70006
Adjusted Total Nurse Staffing Hours per Resident per Day
4.43090
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-02-26
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
36
Cycle 2 Standard Health Survey Date
2014-04-25
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
56
Cycle 3 Standard Health Survey Date
2013-06-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
21.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
6500
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Karlstad Healthcare Center Inc
304 Washington Avenue West |
KARLSTAD MN 56732 | 23.3 miles away
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