Lifecare Greenbush Manor - Greenbush Nursing Home
General Information
UPDATEFederal Provider Number
245616
Provider Name
LIFECARE GREENBUSH MANOR
Provider Address
19120 200TH STREET
GREENBUSH, MN 56726
GREENBUSH, MN 56726
Provider Phone Number
(218) 782-6100
Provider SSA County
670
Provider County Name
Roseau
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
40
Number of Residents in Certified Beds
40
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
LIFECARE MEDICAL CENTER
Date First Approved to Provide Medicare and Medicaid services
2009-04-13
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
3
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
2.33125
Reported LPN Staffing Hours per Resident per Day
1.21500
Reported RN Staffing Hours per Resident per Day
0.78125
Reported Licensed Staffing Hours per Resident per Day
1.99625
Reported Total Nurse Staffing Hours per Resident per Day
4.32750
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01625
Expected CNA Staffing Hours per Resident per Day
2.42023
Expected LPN Staffing Hours per Resident per Day
0.55957
Expected RN Staffing Hours per Resident per Day
0.76288
Expected Total Nurse Staffing Hours per Resident per Day
3.74268
Adjusted CNA Staffing Hours per Resident per Day
2.36349
Adjusted LPN Staffing Hours per Resident per Day
1.80219
Adjusted RN Staffing Hours per Resident per Day
0.76519
Adjusted Total Nurse Staffing Hours per Resident per Day
4.66076
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
16
Cycle 1 Standard Survey Health Date
2015-04-16
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2014-05-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2013-07-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
14.66700
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
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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