Chautauqua Guest Home #2 - Charles City Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165019
Provider Name
CHAUTAUQUA GUEST HOME #2
Provider Address
602 ELEVENTH STREET
CHARLES CITY, IA 50616
CHARLES CITY, IA 50616
Provider Phone Number
(641) 228-2353
Provider SSA County
330
Provider County Name
Floyd
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
61
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CHAUTAUQUA GUEST HOMES INC.
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
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
2.43400
Reported LPN Staffing Hours per Resident per Day
0.59700
Reported RN Staffing Hours per Resident per Day
0.55900
Reported Licensed Staffing Hours per Resident per Day
1.15600
Reported Total Nurse Staffing Hours per Resident per Day
3.59000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02300
Expected CNA Staffing Hours per Resident per Day
2.35430
Expected LPN Staffing Hours per Resident per Day
0.63306
Expected RN Staffing Hours per Resident per Day
1.02555
Expected Total Nurse Staffing Hours per Resident per Day
4.01291
Adjusted CNA Staffing Hours per Resident per Day
2.53676
Adjusted LPN Staffing Hours per Resident per Day
0.78273
Adjusted RN Staffing Hours per Resident per Day
0.40728
Adjusted Total Nurse Staffing Hours per Resident per Day
3.60609
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-10-16
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
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-07-25
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-06-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
12.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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