Shakopee Friendship Manor - Shakopee Nursing Home
General Information
UPDATEFederal Provider Number
245445
Provider Name
SHAKOPEE FRIENDSHIP MANOR
Provider Address
1340 THIRD AVENUE WEST
SHAKOPEE, MN 55379
SHAKOPEE, MN 55379
Provider Phone Number
(952) 445-4155
Provider SSA County
690
Provider County Name
Scott
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
QUALITY LIFE STYLES INC
Date First Approved to Provide Medicare and Medicaid services
1987-03-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
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
2.62538
Reported LPN Staffing Hours per Resident per Day
0.95923
Reported RN Staffing Hours per Resident per Day
0.57154
Reported Licensed Staffing Hours per Resident per Day
1.53077
Reported Total Nurse Staffing Hours per Resident per Day
4.15615
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02231
Expected CNA Staffing Hours per Resident per Day
2.48877
Expected LPN Staffing Hours per Resident per Day
0.53870
Expected RN Staffing Hours per Resident per Day
0.79674
Expected Total Nurse Staffing Hours per Resident per Day
3.82421
Adjusted CNA Staffing Hours per Resident per Day
2.58838
Adjusted LPN Staffing Hours per Resident per Day
1.47792
Adjusted RN Staffing Hours per Resident per Day
0.53600
Adjusted Total Nurse Staffing Hours per Resident per Day
4.38078
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2015-04-09
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2014-03-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
14
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2013-06-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
48.00000
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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