Country Side Estates - Cherokee Nursing Home
General Information
UPDATEFederal Provider Number
165425
Provider Name
COUNTRY SIDE ESTATES
Provider Address
921 RIVERVIEW DRIVE
CHEROKEE, IA 51012
CHEROKEE, IA 51012
Provider Phone Number
7122255724
Provider SSA County
170
Provider County Name
Cherokee
Ownership Type
For profit - Corporation
Number of Certified Beds
48
Number of Residents in Certified Beds
34
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CHEROKEE CARE LLC
Date First Approved to Provide Medicare and Medicaid services
2000-08-25
Continuing Care Retirement Community
N
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.42500
Reported LPN Staffing Hours per Resident per Day
0.70441
Reported RN Staffing Hours per Resident per Day
0.61029
Reported Licensed Staffing Hours per Resident per Day
1.31471
Reported Total Nurse Staffing Hours per Resident per Day
2.73970
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02353
Expected CNA Staffing Hours per Resident per Day
2.56107
Expected LPN Staffing Hours per Resident per Day
0.61550
Expected RN Staffing Hours per Resident per Day
0.91971
Expected Total Nurse Staffing Hours per Resident per Day
4.09628
Adjusted CNA Staffing Hours per Resident per Day
1.36526
Adjusted LPN Staffing Hours per Resident per Day
0.94989
Adjusted RN Staffing Hours per Resident per Day
0.49582
Adjusted Total Nurse Staffing Hours per Resident per Day
2.69597
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-03-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-12-19
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
9
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-11-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
26.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
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
Cherokee Villa Nursing & Rehab
1011 North Roosevelt |
CHEROKEE IA 51012 | 0.5 mile away
Careage Hills Rehabilitation And Healthcare
725 North Second Street |
CHEROKEE IA 51012 | 0.9 mile away
Sunset Knoll Care And Rehab Center
401 West Fifth Street |
AURELIA IA 51005 | 5.7 miles away
Heartland Care Center
604 East Fenton |
MARCUS IA 51035 | 14 miles away
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