Victory Health & Rehabilitation Center
512 49th Avenue North, Minneapolis, MN 55430


Victory Health & Rehabilitation Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 245544. The address is 512 49th Avenue North, Minneapolis, MN 55430. The zip code is 55430. The phone number is 6125297747.


Victory Health & Rehabilitation Center · 512 49th Avenue North, Minneapolis, MN 55430

Federal Provider Number 245544
Provider Name VICTORY HEALTH & REHABILITATION CENTER
Address 512 49TH AVENUE NORTH
MINNEAPOLIS, MN 55430
Phone Number 6125297747
SSA County Code 260
County Name Hennepin
Ownership Type For profit - Corporation
Certified Beds 87
Certified Beds Residents 62
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name 512 49TH AVENUE NORTH LLC
Date First Approved to Provide Medicare Medicaid Services 01/01/1991
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Both
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 1
Health Inspection Rating 1
Quality Measure Rating 3
Staffing Rating 2
RN Staffing Rating 1
Reported CNA Staffing Hours per Resident per Day 2.49839
Reported LPN Staffing Hours per Resident per Day 0.84758
Reported RN Staffing Hours per Resident per Day 0.3121
Reported Licensed Staffing Hours per Resident per Day 1.15968
Reported Total Nurse Staffing Hours per Resident per Day 3.65807
Reported Physical Therapist Staffing Hours per Resident Per Day 0.02419
Expected CNA Staffing Hours per Resident per Day 2.07566
Expected LPN Staffing Hours per Resident per Day 0.60076
Expected RN Staffing Hours per Resident per Day 0.89296
Expected Total Nurse Staffing Hours per Resident per Day 3.56939
Adjusted CNA Staffing Hours per Resident per Day 2.95342
Adjusted LPN Staffing Hours per Resident per Day 1.171
Adjusted RN Staffing Hours per Resident per Day 0.26115
Adjusted Total Nurse Staffing Hours per Resident per Day 4.13105
Cycle 1 Total Number of Health Deficiencies 18
Cycle 1 Number of Standard Health Deficiencies 11
Cycle 1 Number of Complaint Health Deficiencies 7
Cycle 1 Health Deficiency Score 84
Cycle 1 Standard Survey Health Date 03/23/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 84
Cycle 2 Total Number of Health Deficiencies 18
Cycle 2 Number of Standard Health Deficiencies 17
Cycle 2 Number of Complaint Health Deficiencies 1
Cycle 2 Health Deficiency Score 92
Cycle 2 Standard Health Survey Date 01/28/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 92
Cycle 3 Total Number of Health Deficiencies 12
Cycle 3 Number of Standard Health Deficiencies 12
Cycle 3 Health Deficiency Score 80
Cycle 3 Standard Health Survey Date 04/17/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 80
Total Weighted Health Survey Score 86
Number of Facility Reported Incidents 1
Number of Substantiated Complaints 9
Total Amount of Fines in Dollars $0.00
Number of Payment Denials 2
Total Number of Penalties 2
Processing Date 08/01/2017

Owner or Manager · Victory Health & Rehabilitation Center

Owner Name Role Association Date
BRISCOE, DAVID (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
50%
since 06/22/2012
BRISCOE, DAVID (Individual) DIRECTOR since 06/22/2012
BRISCOE, DAVID (Individual) OFFICER since 06/22/2012
DIMENSIONS HEALTH STRATEGIES CORPORATION (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 06/22/2012
HEALTH DIMENSIONS CONSULTING INC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 11/12/2015
SHVETZOFF, SERGEI (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
50%
since 06/22/2012
SHVETZOFF, SERGEI (Individual) DIRECTOR since 06/22/2012
SHVETZOFF, SERGEI (Individual) OFFICER since 06/22/2012
SOLBERG, SHELLEY (Individual) MANAGING EMPLOYEE since 07/15/2016
TOURVILLE, PAMELA (Individual) MANAGING EMPLOYEE since 03/01/2017

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