Dumont Wellness Center - Dumont Nursing Home

General Information

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Federal Provider Number
165339
Provider Name
DUMONT WELLNESS CENTER
Provider Address
921 THIRD STREET
DUMONT, IA 50625
Provider Phone Number
(641) 857-3401
Provider SSA County
110
Provider County Name
Butler
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
38
Number of Residents in Certified Beds
25
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ABCM CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1997-08-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
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
4
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
3.50800
Reported LPN Staffing Hours per Resident per Day
0.57800
Reported RN Staffing Hours per Resident per Day
0.45200
Reported Licensed Staffing Hours per Resident per Day
1.03000
Reported Total Nurse Staffing Hours per Resident per Day
4.53800
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.51182
Expected LPN Staffing Hours per Resident per Day
0.61367
Expected RN Staffing Hours per Resident per Day
0.87586
Expected Total Nurse Staffing Hours per Resident per Day
4.00135
Adjusted CNA Staffing Hours per Resident per Day
3.42683
Adjusted LPN Staffing Hours per Resident per Day
0.78175
Adjusted RN Staffing Hours per Resident per Day
0.38560
Adjusted Total Nurse Staffing Hours per Resident per Day
4.57151
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-04-02
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
0
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
79
Cycle 2 Standard Health Survey Date
2014-03-06
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
79
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
20
Cycle 3 Standard Health Survey Date
2013-02-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
37.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
4713
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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