Iowa Nursing Homes >> Lake View Nursing Homes >> Blackhawk Life Care Center

Blackhawk Life Care Center - Lake View Nursing Home

General Information

UPDATE
Federal Provider Number
165499
Provider Name
BLACKHAWK LIFE CARE CENTER
Provider Address
73 WEST 5TH STREET
LAKE VIEW, IA 51450
Provider Phone Number
7126578527
Provider SSA County
800
Provider County Name
Sac
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
32
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BLACKHAWK LIFECARE INC
Date First Approved to Provide Medicare and Medicaid services
2003-01-02
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
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
2.79688
Reported LPN Staffing Hours per Resident per Day
0.66563
Reported RN Staffing Hours per Resident per Day
0.98750
Reported Licensed Staffing Hours per Resident per Day
1.65313
Reported Total Nurse Staffing Hours per Resident per Day
4.45001
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02656
Expected CNA Staffing Hours per Resident per Day
2.25803
Expected LPN Staffing Hours per Resident per Day
0.53939
Expected RN Staffing Hours per Resident per Day
0.77111
Expected Total Nurse Staffing Hours per Resident per Day
3.56854
Adjusted CNA Staffing Hours per Resident per Day
3.03924
Adjusted LPN Staffing Hours per Resident per Day
1.02425
Adjusted RN Staffing Hours per Resident per Day
0.95687
Adjusted Total Nurse Staffing Hours per Resident per Day
5.02658
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-03-26
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
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
161
Cycle 2 Standard Health Survey Date
2014-01-23
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-11-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
69.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
5753
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01

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