Viking Manor Nursing Home - Ulen Nursing Home
General Information
UPDATEFederal Provider Number
245559
Provider Name
VIKING MANOR NURSING HOME
Provider Address
317 FIRST STREET NORTHWEST
ULEN, MN 56585
ULEN, MN 56585
Provider Phone Number
2185968847
Provider SSA County
130
Provider County Name
Clay
Ownership Type
For profit - Corporation
Number of Certified Beds
45
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CITY OF ULEN & MUNICIPAL LIQUOR STORE & VIKING MANOR
Date First Approved to Provide Medicare and Medicaid services
1991-06-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
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
2.68605
Reported LPN Staffing Hours per Resident per Day
0.48140
Reported RN Staffing Hours per Resident per Day
0.52907
Reported Licensed Staffing Hours per Resident per Day
1.01047
Reported Total Nurse Staffing Hours per Resident per Day
3.69652
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.42090
Expected LPN Staffing Hours per Resident per Day
0.60780
Expected RN Staffing Hours per Resident per Day
0.85225
Expected Total Nurse Staffing Hours per Resident per Day
3.88095
Adjusted CNA Staffing Hours per Resident per Day
2.72245
Adjusted LPN Staffing Hours per Resident per Day
0.65739
Adjusted RN Staffing Hours per Resident per Day
0.46385
Adjusted Total Nurse Staffing Hours per Resident per Day
3.83935
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
99
Cycle 2 Standard Health Survey Date
2014-08-15
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
15
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
120
Cycle 3 Standard Health Survey Date
2013-09-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
120
Total Weighted Health Survey Score
67.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
13618
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Golden Livingcenter - Moorhead
2810 North 2nd Avenue |
MOORHEAD MN 56560 | 26.6 miles away
Eventide Lutheran Home
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MOORHEAD MN 56560 | 28.6 miles away
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