Pleasant Manor Inc - Faribault Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
245090
Provider Name
PLEASANT MANOR INC
Provider Address
27 BRAND AVENUE
FARIBAULT, MN 55021
FARIBAULT, MN 55021
Provider Phone Number
(507) 334-2036
Provider SSA County
650
Provider County Name
Rice
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
65
Number of Residents in Certified Beds
62
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PLEASANT MANOR INC
Date First Approved to Provide Medicare and Medicaid services
1967-01-21
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
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.17984
Reported LPN Staffing Hours per Resident per Day
0.80323
Reported RN Staffing Hours per Resident per Day
0.98226
Reported Licensed Staffing Hours per Resident per Day
1.78548
Reported Total Nurse Staffing Hours per Resident per Day
3.96533
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09194
Expected CNA Staffing Hours per Resident per Day
2.53211
Expected LPN Staffing Hours per Resident per Day
0.59648
Expected RN Staffing Hours per Resident per Day
0.97210
Expected Total Nurse Staffing Hours per Resident per Day
4.10069
Adjusted CNA Staffing Hours per Resident per Day
2.11234
Adjusted LPN Staffing Hours per Resident per Day
1.11769
Adjusted RN Staffing Hours per Resident per Day
0.75501
Adjusted Total Nurse Staffing Hours per Resident per Day
3.89784
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-12-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-12-13
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
2012-10-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
24.00000
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
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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