Davenport Lutheran Home - Davenport Nursing Home
General Information
UPDATEFederal Provider Number
165510
Provider Name
DAVENPORT LUTHERAN HOME
Provider Address
1130 W 53RD STREET
DAVENPORT, IA 52806
DAVENPORT, IA 52806
Provider Phone Number
5633915342
Provider SSA County
810
Provider County Name
Scott
Ownership Type
Non profit - Church related
Number of Certified Beds
98
Number of Residents in Certified Beds
77
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THE LUTHERAN HOME FOR THE AGED ASSOCIATION-EAST
Date First Approved to Provide Medicare and Medicaid services
2004-09-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
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
3.10065
Reported LPN Staffing Hours per Resident per Day
0.64740
Reported RN Staffing Hours per Resident per Day
0.81753
Reported Licensed Staffing Hours per Resident per Day
1.46494
Reported Total Nurse Staffing Hours per Resident per Day
4.56558
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02532
Expected CNA Staffing Hours per Resident per Day
2.53483
Expected LPN Staffing Hours per Resident per Day
0.60370
Expected RN Staffing Hours per Resident per Day
0.90089
Expected Total Nurse Staffing Hours per Resident per Day
4.03941
Adjusted CNA Staffing Hours per Resident per Day
3.00141
Adjusted LPN Staffing Hours per Resident per Day
0.89009
Adjusted RN Staffing Hours per Resident per Day
0.67806
Adjusted Total Nurse Staffing Hours per Resident per Day
4.55596
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-02-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-11-21
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-09-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
38.00000
Number of Facility Reported Incidents
6
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
Nursiong Homes Nearby
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