Clarence Nursing Home - Clarence Nursing Home

General Information

UPDATE
Federal Provider Number
165590
Provider Name
CLARENCE NURSING HOME
Provider Address
402 2ND AVENUE
CLARENCE, IA 52216
Provider Phone Number
5634523262
Provider SSA County
150
Provider County Name
Cedar
Ownership Type
Non profit - Corporation
Number of Certified Beds
46
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CLARENCE NURSING HOME INC
Date First Approved to Provide Medicare and Medicaid services
2009-02-18
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
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
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.24767
Reported LPN Staffing Hours per Resident per Day
0.36163
Reported RN Staffing Hours per Resident per Day
0.62209
Reported Licensed Staffing Hours per Resident per Day
0.98372
Reported Total Nurse Staffing Hours per Resident per Day
3.23139
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08837
Expected CNA Staffing Hours per Resident per Day
2.35599
Expected LPN Staffing Hours per Resident per Day
0.52427
Expected RN Staffing Hours per Resident per Day
0.74251
Expected Total Nurse Staffing Hours per Resident per Day
3.62277
Adjusted CNA Staffing Hours per Resident per Day
2.34089
Adjusted LPN Staffing Hours per Resident per Day
0.57251
Adjusted RN Staffing Hours per Resident per Day
0.62602
Adjusted Total Nurse Staffing Hours per Resident per Day
3.59543
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-04-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-02-20
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
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-01-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
18.00000
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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