Colonial Manor Of Amana - Amana Nursing Home

General Information

UPDATE
Federal Provider Number
165318
Provider Name
COLONIAL MANOR OF AMANA
Provider Address
3207 220TH TRAIL
AMANA, IA 52203
Provider Phone Number
3196223131
Provider SSA County
470
Provider County Name
Iowa
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COLONIAL MANOR OF AMANA INC
Date First Approved to Provide Medicare and Medicaid services
1997-02-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
2.17455
Reported LPN Staffing Hours per Resident per Day
0.39000
Reported RN Staffing Hours per Resident per Day
0.76818
Reported Licensed Staffing Hours per Resident per Day
1.15818
Reported Total Nurse Staffing Hours per Resident per Day
3.33273
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10364
Expected CNA Staffing Hours per Resident per Day
2.42630
Expected LPN Staffing Hours per Resident per Day
0.59713
Expected RN Staffing Hours per Resident per Day
0.90045
Expected Total Nurse Staffing Hours per Resident per Day
3.92388
Adjusted CNA Staffing Hours per Resident per Day
2.19911
Adjusted LPN Staffing Hours per Resident per Day
0.54209
Adjusted RN Staffing Hours per Resident per Day
0.63744
Adjusted Total Nurse Staffing Hours per Resident per Day
3.42363
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2015-02-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
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
2014-02-20
Cycle 2 Number of Health Revisits
0
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
8
Cycle 3 Standard Health Survey Date
2013-01-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
14.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
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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