| General |
| City |
| Cloquet |
Bemidji |
| State attribute explanation |
| Mn |
Mn |
| Street |
| 512 Skyline Boulevard |
1633 Delton Avenue |
| Zip Code |
| 55,720 |
56,601 |
| Phone |
| 2,188,794,641 |
2,184,441,745 |
|
Overall Star Rating |
| 3 |
3 |
|
Health Inspections Star Rating |
| 2 |
2 |
|
Nurse Staffing Star Rating |
| 4 |
4 |
|
Quality Measures Star Rating |
| 3 |
4 |
|
RN Only Star Rating |
| 4 |
3 |
|
Number of Certified Beds |
| 88 |
90 |
| Total Number of Residents |
| 72 |
81 |
|
Percent of Occupied Beds |
| 82 % |
90 % |
| Health Survey Date |
| 12/1/2011 |
12/21/2011 |
| Fire Survey Date |
| 11/29/2011 |
12/20/2011 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| Non Profit - Corporation |
For Profit - Corporation |
| Located Within a Hospital? |
| Yes |
No |
| Multi Nursing Home Ownership? |
| No |
No |
| Resident and Family Councils |
| Resident |
Both |
| Continuing Care Retirement Community? |
| No |
No |
| Quality Indicator Survey? |
| Yes |
Yes |
| Special Focus Facility? |
| No |
No |
| Civil Money Penalty Count |
| 75.2 |
75.2 |
| Total Enforcement Actions Count |
| 1 |
75.2 |
| # of deficiencies |
|
1 |
|
| Staff Information |
| Number of Residents |
| 72 |
81 |
| Number of RN Hours Per Resident Per Day |
| 0.68 |
0.48 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 0.67 |
0.84 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.35 |
1.32 |
| Number of CNA Hours Per Resident Per Day |
| 0.03 |
0.01 |
| Number Therapy Hours Per Resident Per Day |
| 0.03 |
0.01 |
| Environmental Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 2deficiency: Have A Program That Investigates, Controls And Keeps Infection From Spreading.survey Date: 09/15/2010date Of Correction: 11/04/2010 |
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 7.6 % |
33.3 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 1.7 % |
1.7 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 12 % |
14.2 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 4.3 % |
75.2 % |
| Percent of long-stay residents who lose too much weight |
| 12.5 % |
1.4 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 63.6 % |
|
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 4.5 % |
3.9 % |
| Percent of long-stay residents with a urinary tract infection |
| 7.8 % |
11.3 % |
| Percent of long-stay residents who have depressive symptoms |
| 10.8 % |
9.5 % |
| Percent of long-stay residents who were physically restrained |
| 1.50 % |
75.2 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 23.6 % |
30.9 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 85.1 % |
91.7 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 78.4 % |
86.8 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 75.2 % |
75.2 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 3.1 % |
75.2 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 8.8 % |
30.3 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 1.7 % |
1.1 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 17.3:1 |
16 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 1.9 % |
75.2 % |
| Percent of long-stay residents who lose too much weight |
| 9.4 / 10.4 |
2.4 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 55.3 % |
39.3 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 5.6:1 |
3.6 % |
| Percent of long-stay residents with a urinary tract infection |
| 6.9 % |
10 % |
| Percent of long-stay residents who have depressive symptoms |
| 6.9 % |
8.4 % |
| Percent of long-stay residents who were physically restrained |
| 0.5 - 2.0 |
75.2 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 3 % |
3.3 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 26 % |
27.1 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 52.3 % |
92.5 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 81.2 % |
91 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 21.3 % |
6.8 % |