Mount Olivet Home - Minneapolis Nursing Home
General Information
UPDATEFederal Provider Number
240000000000000000000000000000
Provider Name
MOUNT OLIVET HOME
Provider Address
5517 LYNDALE AVENUE SOUTH
MINNEAPOLIS, MN 55419
MINNEAPOLIS, MN 55419
Provider Phone Number
(612) 827-5677
Provider SSA County
260
Provider County Name
Hennepin
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
94
Number of Residents in Certified Beds
92
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1975-01-01
Continuing Care Retirement Community
Y
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
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
0.94837
Reported LPN Staffing Hours per Resident per Day
0.45380
Reported RN Staffing Hours per Resident per Day
0.26685
Reported Licensed Staffing Hours per Resident per Day
0.72065
Reported Total Nurse Staffing Hours per Resident per Day
1.66902
Reported Physical Therapist Staffing Hours per Resident Per Day
0.27120
Expected CNA Staffing Hours per Resident per Day
1.63021
Expected LPN Staffing Hours per Resident per Day
0.50712
Expected RN Staffing Hours per Resident per Day
0.62860
Expected Total Nurse Staffing Hours per Resident per Day
2.76593
Adjusted CNA Staffing Hours per Resident per Day
1.42744
Adjusted LPN Staffing Hours per Resident per Day
0.74273
Adjusted RN Staffing Hours per Resident per Day
0.31720
Adjusted Total Nurse Staffing Hours per Resident per Day
2.43233
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
12
Cycle 1 Standard Survey Health Date
2014-05-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-03-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-07-19
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
8.66700
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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