St John Lutheran Home - Springfield Nursing Home
General Information
UPDATEFederal Provider Number
245407
Provider Name
ST JOHN LUTHERAN HOME
Provider Address
201 SOUTH COUNTY ROAD 5
SPRINGFIELD, MN 56087
SPRINGFIELD, MN 56087
Provider Phone Number
(507) 723-3200
Provider SSA County
70
Provider County Name
Brown
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
85
Number of Residents in Certified Beds
72
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST JOHN LUTHERAN HOME
Date First Approved to Provide Medicare and Medicaid services
1988-11-01
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
4
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
2.53750
Reported LPN Staffing Hours per Resident per Day
0.56944
Reported RN Staffing Hours per Resident per Day
0.62569
Reported Licensed Staffing Hours per Resident per Day
1.19514
Reported Total Nurse Staffing Hours per Resident per Day
3.73263
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00694
Expected CNA Staffing Hours per Resident per Day
2.34185
Expected LPN Staffing Hours per Resident per Day
0.59023
Expected RN Staffing Hours per Resident per Day
0.85241
Expected Total Nurse Staffing Hours per Resident per Day
3.78449
Adjusted CNA Staffing Hours per Resident per Day
2.65869
Adjusted LPN Staffing Hours per Resident per Day
0.80076
Adjusted RN Staffing Hours per Resident per Day
0.54847
Adjusted Total Nurse Staffing Hours per Resident per Day
3.97566
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
2015-03-26
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
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
32
Cycle 2 Standard Health Survey Date
2014-04-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2013-01-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
20.00000
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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