Mercy Medical Center-centerville - Centerville Nursing Home
General Information
UPDATEFederal Provider Number
16E728
Provider Name
MERCY MEDICAL CENTER-CENTERVILLE
Provider Address
ONE ST JOSEPH DRIVE
CENTERVILLE, IA 52544
CENTERVILLE, IA 52544
Provider Phone Number
6414374111
Provider SSA County
30
Provider County Name
Appanoose
Ownership Type
Non profit - Church related
Number of Certified Beds
20
Number of Residents in Certified Beds
20
Provider Type
Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2008-04-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.19000
Reported LPN Staffing Hours per Resident per Day
1.52500
Reported RN Staffing Hours per Resident per Day
0.28500
Reported Licensed Staffing Hours per Resident per Day
1.81000
Reported Total Nurse Staffing Hours per Resident per Day
4.00000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.38278
Expected LPN Staffing Hours per Resident per Day
0.56667
Expected RN Staffing Hours per Resident per Day
0.79306
Expected Total Nurse Staffing Hours per Resident per Day
3.74250
Adjusted CNA Staffing Hours per Resident per Day
2.25518
Adjusted LPN Staffing Hours per Resident per Day
2.23368
Adjusted RN Staffing Hours per Resident per Day
0.26852
Adjusted Total Nurse Staffing Hours per Resident per Day
4.30824
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-01-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-11-14
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-09-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
19.33300
Number of Facility Reported Incidents
1
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
Centerville Nursing & Rehab Ce
1208 East Cross Street |
CENTERVILLE IA 52544 | 1.1 miles away
Golden Age Care Center
1915 South 18th Street |
CENTERVILLE IA 52544 | 2.8 miles away
Putnam County Care Center
1814 Oak Street |
UNIONVILLE MO 63565 | 20.4 miles away
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