HENDRICKS COMMUNITY HOSPITAL ASSN & RETIREMENT HOME
NPI 1154407005
Hospice Care, Community Based in Hendricks, MN

NPI Status: Active since October 31, 2006

Contact Information

503 EAST LINCOLN ST
HENDRICKS, MN
ZIP 56136
Phone: (507) 275-3134
Fax: (507) 275-2242

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  • Organization
  • Hospice Care, Community Based
  • CLIA Number: 24D0405220
  • CLIA Cert. Type: Hospital
  • CLIA Exp. Date: 01-26-2027

About HENDRICKS COMMUNITY HOSPITAL ASSN & RETIREMENT HOME

This page provides the complete NPI Profile along with additional information for Hendricks Community Hospital Assn & Retirement Home, a provider established in Hendricks, Minnesota operating as a Hospice Care, Community Based. The healthcare provider is registered in the NPI registry with number 1154407005 assigned on October 2006. The practitioner's primary taxonomy code is 251G00000X with license number 333819 (MN). The provider is registered as an organization and their NPI record was last updated 8 years ago. The authorized official of this NPI record is Mr. Jeff Gollaher (Ceo)

NPI
1154407005
Provider Name
HENDRICKS COMMUNITY HOSPITAL ASSN & RETIREMENT HOME
Entity Type
Organization
Location Address
503 EAST LINCOLN ST HENDRICKS, MN 56136
Location Phone
(507) 275-3134
Location Fax
(507) 275-2242
Mailing Address
PO BOX 106 HENDRICKS, MN 56136
Mailing Phone
(507) 275-3134
Mailing Fax
(507) 275-2242
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-31-2006
Last Update Date
07-17-2017
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According to the Hospice Quality Reporting Program (HQRP) data this facility is other and was certified on 04-08-1994 This facility was recently evaluated on the following quality measures: average daily census, hospice served at least 1 patient with both medicare and medicaid coverage during one year, hospice served at least 1 patient enrolled in medicare advantage during one year, care provided in assisted living facility and care provided in home, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Hospice Care, Community Based

Taxonomy Code
251G00000X
Type
Agencies
License No.
333819
License State
MN

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1251G00000XAgencies

Hospice Care, Community Based

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. JEFF GOLLAHER

Authorized Official Title
CEO
Authorized Official Phone
(507) 275-3134

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
241540MEDICARE OSCAR/CERTIFICATION (06) 

Hospice Care Information

The Centers for Medicare and Medicaid Services Hospice Quality Reporting Program (HQRP) data provides information on the quality of care that hospice facilities are providing to their patients. The quality reporting data gives families and patients the information they need to decide which hospice is right for them.

CMS Certification Number (CCN)241540
Ownership TypeOther
Medicare Certification Date04-08-1994
Quality Measure Measure Score
Average Daily Census
Number of patients cared for by a hospice on average each day
2.0
Hospice served at least 1 patient with both Medicare and Medicaid coverage during one year
1= Hospice served at least 1 patient with both Medicaid and Medicare coverage OR 0 = Hospice did not serve any patients with both Medicaid and Medicare coverage
Yes
Hospice served at least 1 patient enrolled in Medicare Advantage during one year
1 = Hospice served at least one patient enrolled in Medicare Advantage OR 0 = Hospice did not serve any patients enrolled in Medicare Advantage
Yes
Care Provided in Assisted Living Facility
Percentage of days patients received care in an assisted living facility
Not Available - Number of patients is too small to report.
Care Provided in Home
Percentage of days patients received care in home
21
Care Provided in Inpatient Hospice Facility
Percentage of days patients received care in an inpatient hospice
0 - Value is based on one year of data and does not indicate that the hospice would have 0% in more recent years.
Care Provided in Inpatient Hospital Facility
Percentage of days patients received care in an inpatient hospital
Not Available - Number of patients is too small to report.
Care Provided in Nursing Facility
Percentage of days patients received care in a nursing facility
77
Care Provided in All other locations
Percentage of days patients received care in other locations
Not Available - Number of patients is too small to report.
Care Provided in Skilled Nursing Facility
Percentage of days patients received care in a skilled nursing facility
0 - Value is based on one year of data and does not indicate that the hospice would have 0% in more recent years.
Hospice and Palliative Care Treatment Preferences
Facility observed rate
Not Available - The number of patient stays is too small to report (less than 20 patient stays).
Beliefs & Values Addressed (if desired by the patient)
Facility observed rate
Not Available - The number of patient stays is too small to report (less than 20 patient stays).
Hospice and Palliative Care Pain Screening
Facility observed rate
Not Available - The number of patient stays is too small to report (less than 20 patient stays).
Hospice and Palliative Care Pain Assessment
Facility observed rate
Not Available - The number of patient stays is too small to report (less than 20 patient stays).
Hospice and Palliative Care Dyspnea Screening
Facility observed rate
Not Available - The number of patient stays is too small to report (less than 20 patient stays).
Hospice and Palliative Care Dyspnea Treatment
Facility observed rate
Not Available - The number of patient stays is too small to report (less than 20 patient stays).
Patient Treated with an Opioid Who Are Given a Bowel Regimen
Facility observed rate
Not Available - The number of patient stays is too small to report (less than 20 patient stays).
Hospice and Palliative Care Composite Process Measure
Facility observed rate
Not Available - The number of patient stays is too small to report (less than 20 patient stays).
Hospice Visits in the Last Days of Life
20
Hospice Visits in the Last Days of Life
Facility observed rate
70.0
Hospice Care Index Overall Score
Facility observed rate
10.0
CHC/GIP provided (% days)
1,284
CHC/GIP provided (% days)
Facility observed rate
0.3
CHC/GIP provided (% days)
77
Gaps in nursing visits (% elections)
12
Gaps in nursing visits (% elections)
Facility observed rate
0.0
Gaps in nursing visits (% elections)
1
Early live discharges (% live discharges)
4
Early live discharges (% live discharges)
Facility observed rate
0.0
Early live discharges (% live discharges)
19
Late live discharges (% live discharges)
4
Late live discharges (% live discharges)
Facility observed rate
0.0
Late live discharges (% live discharges)
2
Burdensome transitions, Type 1(% live discharges)
4
Burdensome transitions, Type 1 (% live discharges)
Facility observed rate
0.0
Burdensome transitions, Type 1 (% live discharges)
19
Burdensome transitions, Type 2(% live discharges)
4
Burdensome transitions, Type 2 (% live discharges)
Facility observed rate
0.0
Burdensome transitions, Type 2 (% live discharges)
43
Per-beneficiary spending (U.S. dollars $)
29
Per-beneficiary spending (U.S. dollars $)
Facility observed rate
8,304
Per-beneficiary spending (U.S. dollars $)
7
Nurse care minutes per routine home care days (minutes)
1,269
Nurse care minutes per routine home care days (minutes)
Facility observed rate
18.3
Nurse care minutes per routine home care days (minutes)
91
Skilled nursing minutes on weekends (% minutes)
23,235
Skilled nursing minutes on weekends (% minutes)
Facility observed rate
7.3
Skilled nursing minutes on weekends (% minutes)
43
Visits near death (% decedents)
23
Visits near death (% decedents)
Facility observed rate
95.7
Visits near death (% decedents)
69
Percent of Patients with Cancer
Percentage of patients at hospice who had Cancer as their primary diagnosis
Not Available - Number of patients is too small to report.
Percent of Patients with Circulatory/heart disease
Percentage of patients at hospice who had Circulatory Heart Disease as their primary diagnosis
Not Available - Number of patients is too small to report.
Percent of Patients with Dementia
Percentage of patients at hospice who had Dementia as their primary diagnosis
Not Available - Number of patients is too small to report.
Percent of Patients with Other Conditions
Percentage of patients at hospice who had some other conditions as their primary diagnosis
0 - Value is based on one year of data and does not indicate that the hospice would have 0% in more recent years.
Percent of Patients with Respiratory disease
Percentage of patients at hospice who had Respiratory Disease as their primary diagnosis
0 - Value is based on one year of data and does not indicate that the hospice would have 0% in more recent years.
Percent of Patients with Stroke
Percentage of patients at hospice who had Stroke as their primary diagnosis
Not Available - Number of patients is too small to report.
Provided Routine Home Care and other levels of care
Th hospice had at least one incidence of routine home care and at least one more incidence of care at another level. Blank: hospice only provided care at routine home care level
Yes
Provided Routine Home Care only
The hospice had at least one incidence of RHC over the 3 years, and no incidences of care at any other level. Blank: the hospice had at least one incidence of care at another level
No

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
24D0405220
Facility Type
Hospital
Certificate Effective Date
January 27, 2025
Certificate Expiration Date
January 26, 2027
Laboratory Director
ERIN E. QUIST
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Hendricks Community Hospital Assn & Retirement Home after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1154407005
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
21104801400
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 1 + 0 + 4 + 8 + 0 + 1 + 4 + 0 + 0 + 24 = 45
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 45 = 55

The NPI number 1154407005 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1588742217HENDRICKS COMMUNITY HOSPITAL ASSN & RETIREMENT HOME
Organization
Home Health503 EAST LINCOLN ST
HENDRICKS, MN 56136
(507) 275-3134
1932285061HENDRICKS COMMUNITY HOSPITAL ASSN & RETIREMENT HOME
Organization
Skilled Nursing Facility503 EAST LINCOLN ST
HENDRICKS, MN 56136
(507) 275-3134
1154497527HENDRICKS COMMUNITY HOSPITAL ASSN & RETIREMENT HOME
Organization
Medicare Defined Swing Bed Unit503 EAST LINCOLN ST
HENDRICKS, MN 56136
(507) 275-3134

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154407005, enumerated in the NPI registry as an "organization" on October 31, 2006

The provider is located at 503 East Lincoln St Hendricks, Mn 56136 and the phone number is (507) 275-3134

This medical organization specializes in Hospice Care, Community Based with taxonomy code 251G00000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 24D0405220 for a "hospital" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..

This NPI record was last updated on October 31, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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