Lakeshore Inc - Duluth Nursing Home
General Information
UPDATEFederal Provider Number
245215
Provider Name
LAKESHORE INC
Provider Address
4002 LONDON ROAD
DULUTH, MN 55804
DULUTH, MN 55804
Provider Phone Number
2185251951
Provider SSA County
680
Provider County Name
St. Louis
Ownership Type
Non profit - Church related
Number of Certified Beds
60
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
ECUMEN
Date First Approved to Provide Medicare and Medicaid services
1977-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
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
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
3.25300
Reported LPN Staffing Hours per Resident per Day
0.60000
Reported RN Staffing Hours per Resident per Day
2.43100
Reported Licensed Staffing Hours per Resident per Day
3.03100
Reported Total Nurse Staffing Hours per Resident per Day
6.28400
Reported Physical Therapist Staffing Hours per Resident Per Day
0.23800
Expected CNA Staffing Hours per Resident per Day
2.19610
Expected LPN Staffing Hours per Resident per Day
0.74097
Expected RN Staffing Hours per Resident per Day
1.66013
Expected Total Nurse Staffing Hours per Resident per Day
4.59719
Adjusted CNA Staffing Hours per Resident per Day
3.63458
Adjusted LPN Staffing Hours per Resident per Day
0.67210
Adjusted RN Staffing Hours per Resident per Day
1.09416
Adjusted Total Nurse Staffing Hours per Resident per Day
5.50993
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-06-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-04-15
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
18
Cycle 2 Total Health Score
18
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2011-12-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
48.66700
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
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Aftenro Home
510 West College Street |
DULUTH MN 55811 | 2.3 miles away
Benedictine Health Center
935 Kenwood Avenue |
DULUTH MN 55811 | 3.1 miles away
Chris Jensen Health & Rehabilitation Center
2501 Rice Lake Road |
DULUTH MN 55811 | 4 miles away
Bayshore Residence & Rehab Ctr
1601 St Louis Avenue |
DULUTH MN 55802 | 4.3 miles away
Franciscan Health Center
3910 Minnesota Avenue |
DULUTH MN 55802 | 5.5 miles away
Viewcrest Health Center
3111 Church Street |
DULUTH MN 55811 | 6.2 miles away
St Eligius Health Center
7700 Grand Avenue |
DULUTH MN 55807 | 9.9 miles away
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