Minnesota Masonic Home Care Center - Bloomington Nursing Home
General Information
UPDATEFederal Provider Number
245343
Provider Name
MINNESOTA MASONIC HOME CARE CENTER
Provider Address
11501 MASONIC HOME DRIVE
BLOOMINGTON, MN 55437
BLOOMINGTON, MN 55437
Provider Phone Number
(952) 948-7000
Provider SSA County
260
Provider County Name
Hennepin
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
214
Number of Residents in Certified Beds
212
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MINNESOTA MASONIC HOME CARE CENTER
Date First Approved to Provide Medicare and Medicaid services
1986-09-01
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
4
QM Rating Footnote
Staffing Rating
4
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
2.44057
Reported LPN Staffing Hours per Resident per Day
0.79458
Reported RN Staffing Hours per Resident per Day
1.38491
Reported Licensed Staffing Hours per Resident per Day
2.17948
Reported Total Nurse Staffing Hours per Resident per Day
4.62006
Reported Physical Therapist Staffing Hours per Resident Per Day
0.38915
Expected CNA Staffing Hours per Resident per Day
2.41767
Expected LPN Staffing Hours per Resident per Day
0.64277
Expected RN Staffing Hours per Resident per Day
1.21725
Expected Total Nurse Staffing Hours per Resident per Day
4.27769
Adjusted CNA Staffing Hours per Resident per Day
2.47694
Adjusted LPN Staffing Hours per Resident per Day
1.02603
Adjusted RN Staffing Hours per Resident per Day
0.85012
Adjusted Total Nurse Staffing Hours per Resident per Day
4.35352
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
8
Cycle 1 Standard Survey Health Date
2014-11-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
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
2013-12-05
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
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
2013-02-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
12.00000
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
2
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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