Bethany Manor - Story City Nursing Home
General Information
UPDATEFederal Provider Number
165424
Provider Name
BETHANY MANOR
Provider Address
212 LAFAYETTE STREET
STORY CITY, IA 50248
STORY CITY, IA 50248
Provider Phone Number
5157334325
Provider SSA County
840
Provider County Name
Story
Ownership Type
Non profit - Church related
Number of Certified Beds
180
Number of Residents in Certified Beds
157
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BETHANY MANOR INC
Date First Approved to Provide Medicare and Medicaid services
2000-09-01
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.85605
Reported LPN Staffing Hours per Resident per Day
0.44395
Reported RN Staffing Hours per Resident per Day
0.99045
Reported Licensed Staffing Hours per Resident per Day
1.43439
Reported Total Nurse Staffing Hours per Resident per Day
4.29045
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02834
Expected CNA Staffing Hours per Resident per Day
2.56515
Expected LPN Staffing Hours per Resident per Day
0.60667
Expected RN Staffing Hours per Resident per Day
0.91962
Expected Total Nurse Staffing Hours per Resident per Day
4.09145
Adjusted CNA Staffing Hours per Resident per Day
2.73196
Adjusted LPN Staffing Hours per Resident per Day
0.60738
Adjusted RN Staffing Hours per Resident per Day
0.80475
Adjusted Total Nurse Staffing Hours per Resident per Day
4.22696
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-06-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-04-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-04-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
36.00000
Number of Facility Reported Incidents
7
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Riverside North
3440 Grand Avenue |
AMES IA 50010 | 8.8 miles away
Riverside South
1204 South Fourth Street |
AMES IA 50010 | 11.4 miles away
Green Hills Health Care Center
2200 Hamilton Drive |
AMES IA 50014 | 12.7 miles away
Rolling Green Village Care Cen
100 Sixth Street |
NEVADA IA 50201 | 13.7 miles away
Story County Hospital Ltc
630 South Sixth Street |
NEVADA IA 50201 | 14 miles away
Zearing Health Care, Llc
404 East Garfield St |
ZEARING IA 50278 | 15.4 miles away
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