| General |
| City |
| Elk River |
Woodbury |
| State attribute explanation |
| Mn |
Mn |
| Street |
| 400 Evans Avenue |
7012 Lake Road |
| Zip Code |
| 55,330 |
55,125 |
| Phone |
| 7,632,414,405 |
6,512,876,506 |
|
Overall Star Rating |
| 5 |
2 |
|
Health Inspections Star Rating |
| 4 |
1 |
|
Nurse Staffing Star Rating |
| 4 |
5 |
|
Quality Measures Star Rating |
| 5 |
3 |
|
RN Only Star Rating |
| 4 |
5 |
|
Number of Certified Beds |
| 120 |
190 |
|
Total Number of Residents |
| 111 |
168 |
|
Percent of Occupied Beds |
| 93 % |
88 % |
| Health Survey Date |
| 2/2/2012 |
8/11/2011 |
| Fire Survey Date |
| 2/1/2012 |
8/17/2011 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| Non Profit - Church Related |
Non Profit - Corporation |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| No |
Yes |
| Resident and Family Councils |
| Resident |
Resident |
| Continuing Care Retirement Community? |
| No |
No |
| Quality Indicator Survey? |
| Yes |
Yes |
| Special Focus Facility? |
| No |
No |
| Civil Money Penalty Count |
| 75.2 |
4 |
| Total Enforcement Actions Count |
| 75.2 |
4 |
| # of deficiencies |
| 1 |
10 |
|
| Staff Information |
| Number of Residents |
| 111 |
168 |
| Number of RN Hours Per Resident Per Day |
| 0.88 |
0.98 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 0.75 |
0.83 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.63 |
1.8 |
| Number of CNA Hours Per Resident Per Day |
| 0.07 |
0.06 |
| Number Therapy Hours Per Resident Per Day |
| 0.07 |
0.06 |
| Mistreatment Deficiencies |
| Deficiency #1 |
|
Scope: Somelevel Of Harm: 3deficiency: Develop Policies That Prevent Mistreatment, Neglect, Or Abuse Of Residents Or Theft Of Resident Property.survey Date: 01/28/2011date Of Correction: 03/24/2011 |
| Deficiency #2 |
|
Scope: Somelevel Of Harm: 4deficiency: 1) Hire Only People With No Legal History Of Abusing, Neglecting Or Mistreating Residents; Or 2) Report And Investigate Any Acts Or Reports Of Abuse, Neglect Or Mistreatment Of Residents.survey Date: 01/28/2011date Of Correction: 03/24/2011 |
| Deficiency #3 |
|
Scope: Somelevel Of Harm: 3deficiency: Protect Each Resident From All Abuse, Physical Punishment, And Being Separated From Others.survey Date: 01/28/2011date Of Correction: 03/24/2011 |
| Resident Rights Deficiencies |
| Deficiency #1 |
|
Scope: Somelevel Of Harm: 3deficiency: Provide Care For Residents In A Way That Keeps Or Builds Each Resident's Dignity And Respect Of Individuality.survey Date: 01/28/2011date Of Correction: 03/24/2011 |
| Quality Care Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Provide Necessary Care And Services To Maintain The Highest Well Being Of Each Resident .survey Date: 03/16/2012date Of Correction: 04/12/2012 |
Scope: Fewlevel Of Harm: 2deficiency: Have Enough Nurses To Care For Every Resident In A Way That Maximizes The Resident's Well Being.survey Date: 01/28/2011date Of Correction: 03/24/2011 |
| Deficiency #2 |
|
Scope: Fewlevel Of Harm: 2deficiency: Provide Care By Qualified Persons According To Each Resident's Written Plan Of Care.survey Date: 01/28/2011date Of Correction: 03/24/2011 |
| Deficiency #3 |
|
Scope: Fewlevel Of Harm: 2deficiency: Make Sure That Each Resident Who Enters The Nursing Home Without A Catheter Is Not Given A Catheter, And Receive Proper Services To Prevent Urinary Tract Infections And Restore Normal Bladder Function.survey Date: 04/30/2009date Of Correction: 06/05/2009 |
| Deficiency #4 |
|
Scope: Fewlevel Of Harm: 2deficiency: Give Residents Proper Treatment To Prevent New Bed (pressure) Sores Or Heal Existing Bed Sores.survey Date: 04/30/2009date Of Correction: 06/05/2009 |
| Deficiency #5 |
|
Scope: Somelevel Of Harm: 2deficiency: Provide Care By Qualified Persons According To Each Resident's Written Plan Of Care.survey Date: 04/30/2009date Of Correction: 06/05/2009 |
| Resident Assessment Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 2deficiency: Allow The Resident The Right To Participate In The Planning Or Revision Of The Resident's Care Plan.survey Date: 04/30/2009date Of Correction: 06/05/2009 |
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 9.5 % |
22.8 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 0.5 - 2.0 |
75.2 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 9.4 / 10.4 |
16.9-24 |
| Percent of long-stay high-risk residents with pressure ulcers |
| 4.2 % |
6.2 % |
| Percent of long-stay residents who lose too much weight |
| 75.2 % |
10.6 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 65.9 % |
63 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 2.8 % |
4.6 % |
| Percent of long-stay residents with a urinary tract infection |
| 2.4 % |
1.3 % |
| Percent of long-stay residents who have depressive symptoms |
| 20.9 % |
4.1 % |
| Percent of long-stay residents who were physically restrained |
| 75.2 % |
75.2 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 13.8 % |
20.9 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 97 % |
84.1 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 98.7 % |
93.8 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 1.1 % |
75.2 |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 2.3 % |
5.2 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 12.9 (55.2) |
19.9 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 0.7 % |
1.4 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 8.7 % |
15.7 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 2.3 % |
7.8 % |
| Percent of long-stay residents who lose too much weight |
| 1.6 % |
10.7:1 |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 68 % |
56.8 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 3 % |
5.2 % |
| Percent of long-stay residents with a urinary tract infection |
| 4 % |
2.4 % |
| Percent of long-stay residents who have depressive symptoms |
| 14 % |
3.6 % |
| Percent of long-stay residents who were physically restrained |
| 75.2 % |
75.2 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 2.7 % |
5.1 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 22 % |
21.3 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 93.2 % |
78.4 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 97 % |
93.1 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 15.4 % |
1.4 % |