Casa De Paz Health Care Center - Sioux City Nursing Home
General Information
UPDATEFederal Provider Number
165174
Provider Name
CASA DE PAZ HEALTH CARE CENTER
Provider Address
2121 WEST 19TH STREET
SIOUX CITY, IA 51103
SIOUX CITY, IA 51103
Provider Phone Number
7122333127
Provider SSA County
960
Provider County Name
Woodbury
Ownership Type
For profit - Corporation
Number of Certified Beds
71
Number of Residents in Certified Beds
62
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WAVERLEY - CASA DE PAZ, INC.
Date First Approved to Provide Medicare and Medicaid services
1992-10-28
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
2
QM Rating Footnote
Staffing Rating
2
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
1.79516
Reported LPN Staffing Hours per Resident per Day
0.37016
Reported RN Staffing Hours per Resident per Day
0.98065
Reported Licensed Staffing Hours per Resident per Day
1.35081
Reported Total Nurse Staffing Hours per Resident per Day
3.14597
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03468
Expected CNA Staffing Hours per Resident per Day
2.26995
Expected LPN Staffing Hours per Resident per Day
0.62148
Expected RN Staffing Hours per Resident per Day
1.06269
Expected Total Nurse Staffing Hours per Resident per Day
3.95412
Adjusted CNA Staffing Hours per Resident per Day
1.94048
Adjusted LPN Staffing Hours per Resident per Day
0.49435
Adjusted RN Staffing Hours per Resident per Day
0.68952
Adjusted Total Nurse Staffing Hours per Resident per Day
3.20706
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
131
Cycle 1 Standard Survey Health Date
2014-01-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
131
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2012-11-08
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
20
Cycle 3 Standard Health Survey Date
2011-11-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
74.16700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
4713
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Holy Spirit Retirement Home
1701 West 25th Street |
SIOUX CITY IA 51103 | 0.4 mile away
Westwood Nursing & Rehab Cente
4201 Fieldcrest Drive |
SIOUX CITY IA 51104 | 1.2 miles away
Touchstone Living Center
1800 Indian Hills Drive |
SIOUX CITY IA 51104 | 3 miles away
Hallmark Care Center
3800 Indian Hills Drive |
SIOUX CITY IA 51104 | 3.6 miles away
Sunrise Retirement Community
5501 Gordon Drive East |
SIOUX CITY IA 51106 | 5.6 miles away
Countryside Nursing And Rehabilitation Center
6120 Morningside Avenue |
SIOUX CITY IA 51106 | 6.5 miles away
Embassy Healthcare Community
206 Port Neal Road |
SERGEANT BLUFF IA 51054 | 8.7 miles away
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