Provider Name: GREEN PINE ACRES NURSING HOME
Address: 427 MAIN STREET NORTHEAST, MENAHGA, MN 56464
Phone: (218) 564-4101
County: Wadena (790)
Ownership Type: Government - City
Certified Beds: 65
Average Residents Per Day: 54.5 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: GREEN PINE ACRES NURSING HOME
First Approved Date: June 1, 1991
Affiliated Entity: ()
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Resident
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: 3.27069, LPN Staff Hours Per Day: 0.5868, RN Staff Hours Per Day: 0.6238, Licensed Staff Hours Per Day: 1.2106
Total Nurse Staff Hours Per Day, per resident: 4.48130
Weekend Nurse Staff Hours: 3.70651, Weekend RN Staff Hours: 0.3171
PT Staff Hours Per Day, per resident: 0.0626
Nurse Staff Turnover: 40.3, Nurse Turnover Note:
RN Turnover: 63.6, RN Turnover Note:
Admin Left Number: 0, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.1594, Case Mix LPN Hours Per Day: 0.6527, Case Mix RN Hours Per Day: 0.2999
Adjusted Nurse Aide Hours Per Day, per resident: 3.08560, Adjusted LPN Hours Per Day: 0.6634, Adjusted RN Hours Per Day: 0.7837
Total Adjusted Nurse Hours Per Day, per resident: 4.53884
Adjusted Weekend Nurse Hours Per Day, per resident: 3.75410
Health Survey Dates and Scores: Cycle 1: 2023-07-26 (Score: 8), Cycle 2: 2022-04-28 (Score: 0), Cycle 3: 2020-01-09 (Score: 0)
Total Weighted Health Score: 4.000
Reported Incidents: 0, Substantiated Complaints: 0
Infection Control Citations: 0
Fines and Penalties: Number of Fines: 0, Total Fines in Dollars: 0.00, Payment Denials Number: 0, Total Penalties Number: 0
Location and GPS: 427 MAIN STREET NORTHEAST,MENAHGA,MN,56464 (46.7547, -95.084)
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: Develop and implement policies and procedures for flu and pneumonia vaccinations.
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 2023-09-30
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: 0132, Version: New
Description: Meet requirements for outpatient facilities located next to inpatient facilities separated by fire resistive construction.
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 2023-08-24
Type: Fire Safety, Tag: 0351, Version: New
Description: Install an approved automatic sprinkler system.
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 2023-08-24
Type: Fire Safety, Tag: 0353, Version: New
Description: Inspect, test, and maintain automatic sprinkler systems.
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 2023-08-24
Type: Fire Safety, Tag: 0912, Version: New
Description: Have power receptacles that are properly grounded.
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 2023-08-24
Type: Fire Safety, Tag: 0132, Version: New
Description: Meet requirements for outpatient facilities located next to inpatient facilities separated by fire resistive construction.
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 2022-05-13
Type: Fire Safety, Tag: 0211, Version: New
Description: Keep aisles, corridors, and exits free of obstruction in case of emergency.
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 2022-05-13
Type: Fire Safety, Tag: 0321, Version: New
Description: Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
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 2022-05-20
Type: Fire Safety, Tag: 0324, Version: New
Description: Provide properly protected cooking facilities.
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 2022-05-13
Type: Fire Safety, Tag: 0345, Version: New
Description: Have approved installation, maintenance and testing program for fire alarm 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 2022-05-13
Type: Fire Safety, Tag: 0353, Version: New
Description: Inspect, test, and maintain automatic sprinkler systems.
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 2022-05-20
Type: Fire Safety, Tag: 0712, Version: New
Description: Have simulated fire drills held at unexpected times.
Severity: C - Level 1: No actual harm with potential for minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-05-13
Type: Fire Safety, Tag: 0321, Version: New
Description: Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
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 2020-01-15