Golden Age Care Center - Centerville Nursing Home
General Information
UPDATEFederal Provider Number
165257
Provider Name
GOLDEN AGE CARE CENTER
Provider Address
1915 SOUTH 18TH STREET
CENTERVILLE, IA 52544
CENTERVILLE, IA 52544
Provider Phone Number
6418562757
Provider SSA County
30
Provider County Name
Appanoose
Ownership Type
For profit - Corporation
Number of Certified Beds
70
Number of Residents in Certified Beds
47
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOLDEN AGE PROPERTIES LLC
Date First Approved to Provide Medicare and Medicaid services
1995-06-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
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
2.16915
Reported LPN Staffing Hours per Resident per Day
0.86170
Reported RN Staffing Hours per Resident per Day
0.75851
Reported Licensed Staffing Hours per Resident per Day
1.62021
Reported Total Nurse Staffing Hours per Resident per Day
3.78936
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00957
Expected CNA Staffing Hours per Resident per Day
2.16330
Expected LPN Staffing Hours per Resident per Day
0.58578
Expected RN Staffing Hours per Resident per Day
0.77068
Expected Total Nurse Staffing Hours per Resident per Day
3.51975
Adjusted CNA Staffing Hours per Resident per Day
2.46034
Adjusted LPN Staffing Hours per Resident per Day
1.22095
Adjusted RN Staffing Hours per Resident per Day
0.73541
Adjusted Total Nurse Staffing Hours per Resident per Day
4.33966
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-09-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
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
2013-10-10
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
18
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
14
Cycle 3 Health Deficiency Score
191
Cycle 3 Standard Health Survey Date
2013-05-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
191
Total Weighted Health Survey Score
57.83300
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
10
Number of Fines
1
Total Amount of Fines in Dollars
7150
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Centerville Nursing & Rehab Ce
1208 East Cross Street |
CENTERVILLE IA 52544 | 1.7 miles away
Mercy Medical Center-centerville
One St Joseph Drive |
CENTERVILLE IA 52544 | 2.8 miles away
Putnam County Care Center
1814 Oak Street |
UNIONVILLE MO 63565 | 17.7 miles away
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