Carlisle Center For Wellness And Rehab - Carlisle Nursing Home

General Information

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Federal Provider Number
165255
Provider Name
CARLISLE CENTER FOR WELLNESS AND REHAB
Provider Address
680 COLE STREET
CARLISLE, IA 50047
Provider Phone Number
(515) 989-0871
Provider SSA County
900
Provider County Name
Warren
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
101
Number of Residents in Certified Beds
74
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PACIFICA HEALTH SERVICES 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
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.43716
Reported LPN Staffing Hours per Resident per Day
1.18784
Reported RN Staffing Hours per Resident per Day
0.63311
Reported Licensed Staffing Hours per Resident per Day
1.82095
Reported Total Nurse Staffing Hours per Resident per Day
4.25811
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07432
Expected CNA Staffing Hours per Resident per Day
2.16576
Expected LPN Staffing Hours per Resident per Day
0.57287
Expected RN Staffing Hours per Resident per Day
0.83787
Expected Total Nurse Staffing Hours per Resident per Day
3.57650
Adjusted CNA Staffing Hours per Resident per Day
2.76119
Adjusted LPN Staffing Hours per Resident per Day
1.72098
Adjusted RN Staffing Hours per Resident per Day
0.56460
Adjusted Total Nurse Staffing Hours per Resident per Day
4.79911
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
12
Cycle 1 Health Deficiency Score
120
Cycle 1 Standard Survey Health Date
2014-10-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
120
Cycle 2 Total Number of Health Deficiencies
20
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
14
Cycle 2 Health Deficiency Score
108
Cycle 2 Standard Health Survey Date
2013-08-22
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
54
Cycle 2 Total Health Score
162
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2012-07-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
124.00000
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
34
Number of Fines
2
Total Amount of Fines in Dollars
34678
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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