Bethany Lutheran Home - Council Bluffs Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165524
Provider Name
BETHANY LUTHERAN HOME
Provider Address
SEVEN ELLIOTT STREET
COUNCIL BLUFFS, IA 51503
COUNCIL BLUFFS, IA 51503
Provider Phone Number
(712) 328-9500
Provider SSA County
770
Provider County Name
Pottawattamie
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
121
Number of Residents in Certified Beds
113
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BETHANY LUTHERAN HOME
Date First Approved to Provide Medicare and Medicaid services
2003-11-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.68053
Reported LPN Staffing Hours per Resident per Day
0.97212
Reported RN Staffing Hours per Resident per Day
0.36549
Reported Licensed Staffing Hours per Resident per Day
1.33761
Reported Total Nurse Staffing Hours per Resident per Day
4.01814
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03142
Expected CNA Staffing Hours per Resident per Day
2.48791
Expected LPN Staffing Hours per Resident per Day
0.53846
Expected RN Staffing Hours per Resident per Day
0.73783
Expected Total Nurse Staffing Hours per Resident per Day
3.76420
Adjusted CNA Staffing Hours per Resident per Day
2.64367
Adjusted LPN Staffing Hours per Resident per Day
1.49845
Adjusted RN Staffing Hours per Resident per Day
0.37013
Adjusted Total Nurse Staffing Hours per Resident per Day
4.30283
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
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
32
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2013-04-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
80
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-04-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
49.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
5
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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