Bethany Home - Dubuque Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165584
Provider Name
BETHANY HOME
Provider Address
1005 LINCOLN AVENUE
DUBUQUE, IA 52001
DUBUQUE, IA 52001
Provider Phone Number
(563) 556-5233
Provider SSA County
300
Provider County Name
Dubuque
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
66
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BETHANY HOME
Date First Approved to Provide Medicare and Medicaid services
2009-04-17
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
5
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
2.36692
Reported LPN Staffing Hours per Resident per Day
0.67538
Reported RN Staffing Hours per Resident per Day
0.94308
Reported Licensed Staffing Hours per Resident per Day
1.61846
Reported Total Nurse Staffing Hours per Resident per Day
3.98538
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01538
Expected CNA Staffing Hours per Resident per Day
2.24191
Expected LPN Staffing Hours per Resident per Day
0.52224
Expected RN Staffing Hours per Resident per Day
0.74928
Expected Total Nurse Staffing Hours per Resident per Day
3.51343
Adjusted CNA Staffing Hours per Resident per Day
2.59052
Adjusted LPN Staffing Hours per Resident per Day
1.07338
Adjusted RN Staffing Hours per Resident per Day
0.94046
Adjusted Total Nurse Staffing Hours per Resident per Day
4.57236
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-05-15
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
24
Cycle 2 Standard Health Survey Date
2013-03-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-03-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
16.00000
Number of Facility Reported Incidents
0
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
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