Mcintosh Senior Living - Mcintosh Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
245356
Provider Name
MCINTOSH SENIOR LIVING
Provider Address
600 NORTHEAST RIVERSIDE AVENUE
MCINTOSH, MN 56556
MCINTOSH, MN 56556
Provider Phone Number
(218) 563-2715
Provider SSA County
590
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
45
Number of Residents in Certified Beds
41
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MCINTOSH SENIOR LIVING
Date First Approved to Provide Medicare and Medicaid services
1986-10-01
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
3
QM Rating Footnote
Staffing Rating
2
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
2.90488
Reported LPN Staffing Hours per Resident per Day
0.68415
Reported RN Staffing Hours per Resident per Day
0.27195
Reported Licensed Staffing Hours per Resident per Day
0.95610
Reported Total Nurse Staffing Hours per Resident per Day
3.86098
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02561
Expected CNA Staffing Hours per Resident per Day
2.59268
Expected LPN Staffing Hours per Resident per Day
0.62377
Expected RN Staffing Hours per Resident per Day
0.81372
Expected Total Nurse Staffing Hours per Resident per Day
4.03017
Adjusted CNA Staffing Hours per Resident per Day
2.74917
Adjusted LPN Staffing Hours per Resident per Day
0.91034
Adjusted RN Staffing Hours per Resident per Day
0.24972
Adjusted Total Nurse Staffing Hours per Resident per Day
3.86168
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-01-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
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
28
Cycle 2 Standard Health Survey Date
2013-10-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
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
36
Cycle 3 Standard Health Survey Date
2012-11-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
27.33300
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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