Lakeshore Inn Nursing Home - Waseca Nursing Home

General Information

UPDATE
Federal Provider Number
245388
Provider Name
LAKESHORE INN NURSING HOME
Provider Address
108 8TH STREET NORTHWEST
WASECA, MN 56093
Provider Phone Number
5078352800
Provider SSA County
800
Provider County Name
Waseca
Ownership Type
For profit - Corporation
Number of Certified Beds
55
Number of Residents in Certified Beds
49
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LAKE SHORE IN NURSING HOME INC
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
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.67245
Reported LPN Staffing Hours per Resident per Day
0.53878
Reported RN Staffing Hours per Resident per Day
0.23980
Reported Licensed Staffing Hours per Resident per Day
0.77857
Reported Total Nurse Staffing Hours per Resident per Day
3.45103
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.50693
Expected LPN Staffing Hours per Resident per Day
0.56480
Expected RN Staffing Hours per Resident per Day
0.86939
Expected Total Nurse Staffing Hours per Resident per Day
3.94111
Adjusted CNA Staffing Hours per Resident per Day
2.61571
Adjusted LPN Staffing Hours per Resident per Day
0.79176
Adjusted RN Staffing Hours per Resident per Day
0.20610
Adjusted Total Nurse Staffing Hours per Resident per Day
3.52965
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-07-24
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
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-09-12
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-06-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
26.00000
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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