Villa St Vincent - Crookston Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
245484
Provider Name
VILLA ST VINCENT
Provider Address
516 WALSH STREET
CROOKSTON, MN 56716
CROOKSTON, MN 56716
Provider Phone Number
(218) 281-3424
Provider SSA County
590
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
104
Number of Residents in Certified Beds
101
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
VILLA ST, VINCENT
Date First Approved to Provide Medicare and Medicaid services
1987-06-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
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
3
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
2.61881
Reported LPN Staffing Hours per Resident per Day
0.84802
Reported RN Staffing Hours per Resident per Day
0.64703
Reported Licensed Staffing Hours per Resident per Day
1.49505
Reported Total Nurse Staffing Hours per Resident per Day
4.11386
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05495
Expected CNA Staffing Hours per Resident per Day
2.47877
Expected LPN Staffing Hours per Resident per Day
0.57105
Expected RN Staffing Hours per Resident per Day
0.85884
Expected Total Nurse Staffing Hours per Resident per Day
3.90866
Adjusted CNA Staffing Hours per Resident per Day
2.59232
Adjusted LPN Staffing Hours per Resident per Day
1.23257
Adjusted RN Staffing Hours per Resident per Day
0.56292
Adjusted Total Nurse Staffing Hours per Resident per Day
4.24252
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
52
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
52
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-11-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
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
32
Total Weighted Health Survey Score
46.00000
Number of Facility Reported Incidents
1
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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