Minnesota Nursing Homes >> Pelican Rapids Nursing Homes >> Pelican Valley Health Center

Pelican Valley Health Center - Pelican Rapids Nursing Home

General Information

UPDATE
Federal Provider Number
245373
Provider Name
PELICAN VALLEY HEALTH CENTER
Provider Address
211 EAST MILL AVENUE
PELICAN RAPIDS, MN 56572
Provider Phone Number
2188632991
Provider SSA County
550
Provider County Name
Otter Tail
Ownership Type
Government - Hospital district
Number of Certified Beds
36
Number of Residents in Certified Beds
28
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PELICAN VALLEY HEALTH CENTER
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
4
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
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
3.03929
Reported LPN Staffing Hours per Resident per Day
0.78929
Reported RN Staffing Hours per Resident per Day
1.32679
Reported Licensed Staffing Hours per Resident per Day
2.11607
Reported Total Nurse Staffing Hours per Resident per Day
5.15537
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02500
Expected CNA Staffing Hours per Resident per Day
2.81607
Expected LPN Staffing Hours per Resident per Day
0.63993
Expected RN Staffing Hours per Resident per Day
0.96596
Expected Total Nurse Staffing Hours per Resident per Day
4.42196
Adjusted CNA Staffing Hours per Resident per Day
2.64820
Adjusted LPN Staffing Hours per Resident per Day
1.02372
Adjusted RN Staffing Hours per Resident per Day
1.02631
Adjusted Total Nurse Staffing Hours per Resident per Day
4.69945
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
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
20
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
115
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
0
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-11-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
50.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
10530
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01

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