Provider Name: COUNTRY MANOR HEALTH & REHAB CTR
Address: 520 FIRST STREET NORTHEAST, SARTELL, MN 56377
Phone: (320) 253-1920
County: Stearns (720)
Ownership Type: Non profit - Corporation
Certified Beds: 131
Average Residents Per Day: 114. ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: COUNTRY MANOR CAMPUS LLC
First Approved Date: July 1, 1986
Affiliated Entity: ()
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Both
Sprinkler System Status: Yes
Overall Rating: 5 ()
Health Inspection Rating: 5 ()
QM Rating: 5 ()
Long Stay QM Rating: 5 ()
Short Stay QM Rating: 5 ()
Staffing Rating: 4 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 3.65662, LPN Staff Hours Per Day: 1.1052, RN Staff Hours Per Day: 0.6188, Licensed Staff Hours Per Day: 1.7241
Total Nurse Staff Hours Per Day, per resident: 5.38078
Weekend Nurse Staff Hours: 4.40800, Weekend RN Staff Hours: 0.2306
PT Staff Hours Per Day, per resident: 0.2200
Nurse Staff Turnover: 46.0, Nurse Turnover Note:
RN Turnover: 42.3, RN Turnover Note:
Admin Left Number: 1, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.1960, Case Mix LPN Hours Per Day: 0.6680, Case Mix RN Hours Per Day: 0.3216
Adjusted Nurse Aide Hours Per Day, per resident: 3.39215, Adjusted LPN Hours Per Day: 1.2209, Adjusted RN Hours Per Day: 0.7250
Total Adjusted Nurse Hours Per Day, per resident: 5.32377
Adjusted Weekend Nurse Hours Per Day, per resident: 4.36130
Health Survey Dates and Scores: Cycle 1: 2023-11-30 (Score: 8), Cycle 2: 2022-10-12 (Score: 4), Cycle 3: 2021-08-16 (Score: 16)
Total Weighted Health Score: 8.000
Reported Incidents: 2, Substantiated Complaints: 1
Infection Control Citations:
Fines and Penalties: Number of Fines: 1, Total Fines in Dollars: 5000.00, Payment Denials Number: 1, Total Penalties Number: 2
Location and GPS: 520 FIRST STREET NORTHEAST,SARTELL,MN,56377 (45.6172, -94.190)
Process Date: 2024-03-01
Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Health, Deficiency: Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2024-01-03
Type: Health, Deficiency: Provide routine and 24-hour emergency dental care for each resident.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2024-01-03
Type: Health, Deficiency: Ensure that residents are free from significant medication errors.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-07-20
Type: Health, Deficiency: Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2021-10-04
Type: Health, Deficiency: Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2021-09-27
Type: Health, Deficiency: Provide and implement an infection prevention and control program.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2021-09-27
Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Fire Safety, Tag: 0041, Version: New
Description: Implement emergency and standby power systems.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2024-01-03
Type: Fire Safety, Tag: 0918, Version: New
Description: Have generator or other power source capable of supplying service within 10 seconds.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-12-29
Type: Fire Safety, Tag: 0341, Version: New
Description: Install a fire alarm system that can be heard throughout the facility.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-11-03
Type: Fire Safety, Tag: 0353, Version: New
Description: Inspect, test, and maintain automatic sprinkler systems.
Severity: C - Level 1: No actual harm with potential for minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-11-03