Elm Crest Retirement Community - Harlan Nursing Home

General Information

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Federal Provider Number
165372
Provider Name
ELM CREST RETIREMENT COMMUNITY
Provider Address
2104 12TH STREET
HARLAN, IA 51537
Provider Phone Number
(712) 755-5174
Provider SSA County
820
Provider County Name
Shelby
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
71
Number of Residents in Certified Beds
67
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AMERICAN BAPTIST HOMES OF THE MIDWEST
Date First Approved to Provide Medicare and Medicaid services
1997-10-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
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
2.44328
Reported LPN Staffing Hours per Resident per Day
0.56194
Reported RN Staffing Hours per Resident per Day
1.06418
Reported Licensed Staffing Hours per Resident per Day
1.62612
Reported Total Nurse Staffing Hours per Resident per Day
4.06940
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08507
Expected CNA Staffing Hours per Resident per Day
2.37420
Expected LPN Staffing Hours per Resident per Day
0.58539
Expected RN Staffing Hours per Resident per Day
0.85655
Expected Total Nurse Staffing Hours per Resident per Day
3.81614
Adjusted CNA Staffing Hours per Resident per Day
2.52509
Adjusted LPN Staffing Hours per Resident per Day
0.79675
Adjusted RN Staffing Hours per Resident per Day
0.92832
Adjusted Total Nurse Staffing Hours per Resident per Day
4.29841
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-09-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2013-07-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
88
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
28
Cycle 3 Standard Health Survey Date
2012-07-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
46.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
3
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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