Mennonite Home - Albany Nursing Home
General Information
UPDATEFederal Provider Number
385206
Provider Name
MENNONITE HOME
Provider Address
5353 COLUMBUS STREET SE
ALBANY, OR 97321
ALBANY, OR 97321
Provider Phone Number
(541) 928-7232
Provider SSA County
210
Provider County Name
Linn
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
95
Number of Residents in Certified Beds
90
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MENNONITE HOME OF ALBANY, INC
Date First Approved to Provide Medicare and Medicaid services
1989-08-11
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
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
3.07778
Reported LPN Staffing Hours per Resident per Day
0.68333
Reported RN Staffing Hours per Resident per Day
0.88500
Reported Licensed Staffing Hours per Resident per Day
1.56833
Reported Total Nurse Staffing Hours per Resident per Day
4.64611
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06333
Expected CNA Staffing Hours per Resident per Day
2.52870
Expected LPN Staffing Hours per Resident per Day
0.63480
Expected RN Staffing Hours per Resident per Day
0.98620
Expected Total Nurse Staffing Hours per Resident per Day
4.14970
Adjusted CNA Staffing Hours per Resident per Day
2.98649
Adjusted LPN Staffing Hours per Resident per Day
0.89345
Adjusted RN Staffing Hours per Resident per Day
0.67052
Adjusted Total Nurse Staffing Hours per Resident per Day
4.51310
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-04-11
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2012-09-14
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
112
Cycle 3 Standard Health Survey Date
2011-05-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
112
Total Weighted Health Survey Score
18.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
Number of Fines
3
Total Amount of Fines in Dollars
4063
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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