Davis Center - Bloomfield Nursing Home
General Information
UPDATEFederal Provider Number
16F001
Provider Name
DAVIS CENTER
Provider Address
22425 OVERLAND AVENUE
BLOOMFIELD, IA 52537
BLOOMFIELD, IA 52537
Provider Phone Number
6416643202
Provider SSA County
250
Provider County Name
Davis
Ownership Type
For profit - Corporation
Number of Certified Beds
25
Number of Residents in Certified Beds
21
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1995-03-16
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
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.94524
Reported LPN Staffing Hours per Resident per Day
0.67619
Reported RN Staffing Hours per Resident per Day
1.48333
Reported Licensed Staffing Hours per Resident per Day
2.15952
Reported Total Nurse Staffing Hours per Resident per Day
5.10476
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.08878
Expected LPN Staffing Hours per Resident per Day
0.54447
Expected RN Staffing Hours per Resident per Day
0.72868
Expected Total Nurse Staffing Hours per Resident per Day
3.36194
Adjusted CNA Staffing Hours per Resident per Day
3.45978
Adjusted LPN Staffing Hours per Resident per Day
1.03080
Adjusted RN Staffing Hours per Resident per Day
1.52102
Adjusted Total Nurse Staffing Hours per Resident per Day
6.12051
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-03-06
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-02-07
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
12
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2012-01-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
28.66700
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
Nursiong Homes Nearby
Bloomfield Care Center
800 North Davis Street |
BLOOMFIELD IA 52537 | 4.4 miles away
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