Deerfield Retirement Community Inc - Urbandale Nursing Home
General Information
UPDATEFederal Provider Number
165557
Provider Name
DEERFIELD RETIREMENT COMMUNITY INC
Provider Address
13731 HICKMAN ROAD
URBANDALE, IA 50323
URBANDALE, IA 50323
Provider Phone Number
5152670438
Provider SSA County
760
Provider County Name
Polk
Ownership Type
Non profit - Corporation
Number of Certified Beds
30
Number of Residents in Certified Beds
30
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
DEERFIELD RETIREMENT COMMUNITY INC
Date First Approved to Provide Medicare and Medicaid services
2005-07-22
Continuing Care Retirement Community
Y
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
4
Overall Rating Footnote
Health Inspection Rating
2
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
3.08333
Reported LPN Staffing Hours per Resident per Day
1.30000
Reported RN Staffing Hours per Resident per Day
0.95167
Reported Licensed Staffing Hours per Resident per Day
2.25167
Reported Total Nurse Staffing Hours per Resident per Day
5.33500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09500
Expected CNA Staffing Hours per Resident per Day
2.63257
Expected LPN Staffing Hours per Resident per Day
0.57689
Expected RN Staffing Hours per Resident per Day
0.91759
Expected Total Nurse Staffing Hours per Resident per Day
4.12706
Adjusted CNA Staffing Hours per Resident per Day
2.87383
Adjusted LPN Staffing Hours per Resident per Day
1.87036
Adjusted RN Staffing Hours per Resident per Day
0.77495
Adjusted Total Nurse Staffing Hours per Resident per Day
5.21069
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2015-03-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2014-01-13
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-10-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
32.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
6
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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Fountain West Health Center
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Manorcare Health Services -west Des Moines
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WEST DES MOINES IA 50265 | 5.6 miles away
Childserve Habilitation Center
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Iowa Jewish Senior Life Center
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Bishop Drumm Care Center
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