Edgewood Convalescent Home - Edgewood Nursing Home

General Information

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Federal Provider Number
165379
Provider Name
EDGEWOOD CONVALESCENT HOME
Provider Address
513 BELL STREET
EDGEWOOD, IA 52042
Provider Phone Number
(563) 928-6461
Provider SSA County
210
Provider County Name
Clayton
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
58
Number of Residents in Certified Beds
56
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EDGEWOOD CONVALESCENT HOME
Date First Approved to Provide Medicare and Medicaid services
1998-01-01
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
4
QM Rating Footnote
Staffing Rating
2
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
1.75625
Reported LPN Staffing Hours per Resident per Day
0.59732
Reported RN Staffing Hours per Resident per Day
0.49643
Reported Licensed Staffing Hours per Resident per Day
1.09375
Reported Total Nurse Staffing Hours per Resident per Day
2.85000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02143
Expected CNA Staffing Hours per Resident per Day
2.47329
Expected LPN Staffing Hours per Resident per Day
0.55340
Expected RN Staffing Hours per Resident per Day
0.77013
Expected Total Nurse Staffing Hours per Resident per Day
3.79682
Adjusted CNA Staffing Hours per Resident per Day
1.74234
Adjusted LPN Staffing Hours per Resident per Day
0.89587
Adjusted RN Staffing Hours per Resident per Day
0.48165
Adjusted Total Nurse Staffing Hours per Resident per Day
3.02571
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-05-01
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-01-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-01-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
14.66700
Number of Facility Reported Incidents
3
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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