Madison Lutheran Home - Madison Nursing Home
General Information
UPDATEFederal Provider Number
245382
Provider Name
MADISON LUTHERAN HOME
Provider Address
900 SECOND AVENUE
MADISON, MN 56256
MADISON, MN 56256
Provider Phone Number
(320) 598-7536
Provider SSA County
360
Provider County Name
Lac Qui Parle
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
65
Number of Residents in Certified Beds
62
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AMERICAN LUTHERAN CHURCH MADISON LUTHERAN 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
Both
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
2.29355
Reported LPN Staffing Hours per Resident per Day
0.67984
Reported RN Staffing Hours per Resident per Day
0.68548
Reported Licensed Staffing Hours per Resident per Day
1.36532
Reported Total Nurse Staffing Hours per Resident per Day
3.65887
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.41549
Expected LPN Staffing Hours per Resident per Day
0.58764
Expected RN Staffing Hours per Resident per Day
0.88622
Expected Total Nurse Staffing Hours per Resident per Day
3.88935
Adjusted CNA Staffing Hours per Resident per Day
2.32983
Adjusted LPN Staffing Hours per Resident per Day
0.96022
Adjusted RN Staffing Hours per Resident per Day
0.57795
Adjusted Total Nurse Staffing Hours per Resident per Day
3.79204
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2014-05-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-04-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
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
68
Cycle 3 Standard Health Survey Date
2012-06-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
68.00000
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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