Provider Name: LIFECARE GREENBUSH MANOR
Address: 19120 200TH STREET, GREENBUSH, MN 56726
Phone: (218) 782-2131
County: Roseau (670)
Ownership Type: Non profit - Corporation
Certified Beds: 40
Average Residents Per Day: 29.2 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: LIFECARE MEDICAL CENTER
First Approved Date: April 13, 2009
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: 4 ()
Long Stay QM Rating: 4 ()
Short Stay QM Rating: (2)
Staffing Rating: 4 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.79632, LPN Staff Hours Per Day: 0.5470, RN Staff Hours Per Day: 1.2677, Licensed Staff Hours Per Day: 1.8148
Total Nurse Staff Hours Per Day, per resident: 4.61114
Weekend Nurse Staff Hours: 4.05742, Weekend RN Staff Hours: 0.7011
PT Staff Hours Per Day, per resident: 0.0112
Nurse Staff Turnover: 69.6, Nurse Turnover Note:
RN Turnover: 81.3, RN Turnover Note:
Admin Left Number: , Admin Turnover Note: 6
Case Mix Nurse Aide Hours Per Day, per resident: 1.9560, Case Mix LPN Hours Per Day: 0.6098, Case Mix RN Hours Per Day: 0.2644
Adjusted Nurse Aide Hours Per Day, per resident: 2.91235, Adjusted LPN Hours Per Day: 0.6620, Adjusted RN Hours Per Day: 1.8067
Total Adjusted Nurse Hours Per Day, per resident: 5.13527
Adjusted Weekend Nurse Hours Per Day, per resident: 4.51862
Health Survey Dates and Scores: Cycle 1: 2023-04-13 (Score: 12), Cycle 2: 2021-06-17 (Score: 8), Cycle 3: 2019-01-16 (Score: 20)
Total Weighted Health Score: 12.000
Reported Incidents: 1, Substantiated Complaints: 0
Infection Control Citations:
Fines and Penalties: Number of Fines: 0, Total Fines in Dollars: 0.00, Payment Denials Number: 0, Total Penalties Number: 0
Location and GPS: 19120 200TH STREET,GREENBUSH,MN,56726 (48.7173, -96.183)
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: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
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 2023-05-31
Type: Health, Deficiency: Provide safe, appropriate pain management for a resident who requires such services.
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 2023-05-31
Type: Health, Deficiency: Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
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 2023-05-31
Type: Health, Deficiency: Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
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 2021-07-31
Type: Health, Deficiency: Respond appropriately to all alleged violations.
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 2021-07-31
Type: Health, Deficiency: Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
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 2019-02-21
Type: Health, Deficiency: Provide and implement an infection prevention and control program.
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 2019-02-21
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: 0351, Version: New
Description: Install an approved automatic sprinkler system.
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 2023-04-12
Type: Fire Safety, Tag: 0712, Version: New
Description: Have simulated fire drills held at unexpected times.
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 2023-05-03
Type: Fire Safety, Tag: 0371, Version: New
Description: Have properly sized and located compartments to protect residents from smoke.
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 2019-01-22