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Donnellson Health Center - Donnellson Nursing Home

General Information

UPDATE
Federal Provider Number
165260
Provider Name
DONNELLSON HEALTH CENTER
Provider Address
901 STATE STREET
DONNELLSON, IA 52625
Provider Phone Number
3198355621
Provider SSA County
550
Provider County Name
Lee
Ownership Type
For profit - Corporation
Number of Certified Beds
55
Number of Residents in Certified Beds
48
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DONNELLSON HEALTH CENTER, INC.
Date First Approved to Provide Medicare and Medicaid services
1995-09-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
2.46354
Reported LPN Staffing Hours per Resident per Day
0.70729
Reported RN Staffing Hours per Resident per Day
0.85625
Reported Licensed Staffing Hours per Resident per Day
1.56354
Reported Total Nurse Staffing Hours per Resident per Day
4.02708
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00625
Expected CNA Staffing Hours per Resident per Day
2.39381
Expected LPN Staffing Hours per Resident per Day
0.56538
Expected RN Staffing Hours per Resident per Day
0.85346
Expected Total Nurse Staffing Hours per Resident per Day
3.81265
Adjusted CNA Staffing Hours per Resident per Day
2.52518
Adjusted LPN Staffing Hours per Resident per Day
1.03832
Adjusted RN Staffing Hours per Resident per Day
0.74964
Adjusted Total Nurse Staffing Hours per Resident per Day
4.25761
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-07-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-06-06
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
6
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-04-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
17.33300
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

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