St Raphaels Health & Rehab Center - Eveleth Nursing Home
General Information
UPDATEFederal Provider Number
245277
Provider Name
ST RAPHAELS HEALTH & REHAB CENTER
Provider Address
601 GRANT AVENUE
EVELETH, MN 55734
EVELETH, MN 55734
Provider Phone Number
(218) 744-9800
Provider SSA County
680
Provider County Name
St. Louis
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
76
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ARROWHEAD SENIOR LIVING COMMUNITY
Date First Approved to Provide Medicare and Medicaid services
1985-04-01
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
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.28273
Reported LPN Staffing Hours per Resident per Day
1.11455
Reported RN Staffing Hours per Resident per Day
0.54091
Reported Licensed Staffing Hours per Resident per Day
1.65545
Reported Total Nurse Staffing Hours per Resident per Day
3.93819
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06000
Expected CNA Staffing Hours per Resident per Day
2.57663
Expected LPN Staffing Hours per Resident per Day
0.61228
Expected RN Staffing Hours per Resident per Day
0.94655
Expected Total Nurse Staffing Hours per Resident per Day
4.13546
Adjusted CNA Staffing Hours per Resident per Day
2.17382
Adjusted LPN Staffing Hours per Resident per Day
1.51088
Adjusted RN Staffing Hours per Resident per Day
0.42699
Adjusted Total Nurse Staffing Hours per Resident per Day
3.83862
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
16
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
16
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2014-05-23
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
20
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2013-03-28
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
30
Cycle 3 Total Health Score
90
Total Weighted Health Survey Score
43.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
2275
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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