Carroll Health Center - Carroll Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165455
Provider Name
CARROLL HEALTH CENTER
Provider Address
2241 NORTH WEST STREET
CARROLL, IA 51401
CARROLL, IA 51401
Provider Phone Number
(712) 792-9284
Provider SSA County
130
Provider County Name
Carroll
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
110
Number of Residents in Certified Beds
76
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HAWKEYE CARE CENTER OF CARROLL
Date First Approved to Provide Medicare and Medicaid services
2002-04-15
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
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
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.38487
Reported LPN Staffing Hours per Resident per Day
0.80329
Reported RN Staffing Hours per Resident per Day
0.52763
Reported Licensed Staffing Hours per Resident per Day
1.33092
Reported Total Nurse Staffing Hours per Resident per Day
3.71579
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01053
Expected CNA Staffing Hours per Resident per Day
2.31629
Expected LPN Staffing Hours per Resident per Day
0.61157
Expected RN Staffing Hours per Resident per Day
0.93265
Expected Total Nurse Staffing Hours per Resident per Day
3.86051
Adjusted CNA Staffing Hours per Resident per Day
2.52635
Adjusted LPN Staffing Hours per Resident per Day
1.09020
Adjusted RN Staffing Hours per Resident per Day
0.42272
Adjusted Total Nurse Staffing Hours per Resident per Day
3.87980
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-04-23
Cycle 1 Number of Health Revisits
0
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
13
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
76
Cycle 2 Standard Health Survey Date
2014-02-04
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
76
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-11-29
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
20
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
51.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
8
Number of Fines
1
Total Amount of Fines in Dollars
1170
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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