Clearview Home - Mount Ayr Nursing Home

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Federal Provider Number
165269
Provider Name
CLEARVIEW HOME
Provider Address
406 WEST WASHINGTON
MOUNT AYR, IA 50854
Provider Phone Number
(641) 464-2240
Provider SSA County
790
Provider County Name
Ringgold
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
82
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CLEARVIEW - ROUTH LP
Date First Approved to Provide Medicare and Medicaid services
1996-05-03
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
3
Overall Rating Footnote
Health Inspection Rating
4
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
2.60933
Reported LPN Staffing Hours per Resident per Day
0.50267
Reported RN Staffing Hours per Resident per Day
0.65867
Reported Licensed Staffing Hours per Resident per Day
1.16133
Reported Total Nurse Staffing Hours per Resident per Day
3.77067
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02267
Expected CNA Staffing Hours per Resident per Day
2.33198
Expected LPN Staffing Hours per Resident per Day
0.55128
Expected RN Staffing Hours per Resident per Day
0.72793
Expected Total Nurse Staffing Hours per Resident per Day
3.61119
Adjusted CNA Staffing Hours per Resident per Day
2.74553
Adjusted LPN Staffing Hours per Resident per Day
0.75681
Adjusted RN Staffing Hours per Resident per Day
0.67611
Adjusted Total Nurse Staffing Hours per Resident per Day
4.20891
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
8
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
8
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-08-22
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-07-26
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
10.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
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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Mount Ayr Health Care Center

1504 East South Street | MOUNT AYR IA 50854 | 0.8 mile away