Colonial Manor Of Elma - Elma Nursing Home

General Information

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Federal Provider Number
165386
Provider Name
COLONIAL MANOR OF ELMA
Provider Address
407 9TH STREET
ELMA, IA 50628
Provider Phone Number
(641) 393-2134
Provider SSA County
440
Provider County Name
Howard
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
57
Number of Residents in Certified Beds
34
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COLONIAL MANOR OF ELMA, INC.
Date First Approved to Provide Medicare and Medicaid services
1998-06-01
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
5
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
2.21029
Reported LPN Staffing Hours per Resident per Day
0.67353
Reported RN Staffing Hours per Resident per Day
0.58676
Reported Licensed Staffing Hours per Resident per Day
1.26029
Reported Total Nurse Staffing Hours per Resident per Day
3.47058
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03529
Expected CNA Staffing Hours per Resident per Day
2.06980
Expected LPN Staffing Hours per Resident per Day
0.54160
Expected RN Staffing Hours per Resident per Day
0.85885
Expected Total Nurse Staffing Hours per Resident per Day
3.47025
Adjusted CNA Staffing Hours per Resident per Day
2.62024
Adjusted LPN Staffing Hours per Resident per Day
1.03219
Adjusted RN Staffing Hours per Resident per Day
0.51048
Adjusted Total Nurse Staffing Hours per Resident per Day
4.03128
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-10-02
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
4
Cycle 2 Standard Health Survey Date
2013-07-03
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-05-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
4.00000
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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