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Elm Heights Care Center - Shenandoah Nursing Home

General Information

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Federal Provider Number
165529
Provider Name
ELM HEIGHTS CARE CENTER
Provider Address
1203 SOUTH ELM STREET
SHENANDOAH, IA 51601
Provider Phone Number
(712) 246-4627
Provider SSA County
720
Provider County Name
Page
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
42
Number of Residents in Certified Beds
39
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SHENANDOAH MEDICAL CENTER
Date First Approved to Provide Medicare and Medicaid services
2004-04-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
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
2.66923
Reported LPN Staffing Hours per Resident per Day
0.55897
Reported RN Staffing Hours per Resident per Day
0.81795
Reported Licensed Staffing Hours per Resident per Day
1.37692
Reported Total Nurse Staffing Hours per Resident per Day
4.04615
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03718
Expected CNA Staffing Hours per Resident per Day
2.36697
Expected LPN Staffing Hours per Resident per Day
0.56104
Expected RN Staffing Hours per Resident per Day
0.78753
Expected Total Nurse Staffing Hours per Resident per Day
3.71554
Adjusted CNA Staffing Hours per Resident per Day
2.76704
Adjusted LPN Staffing Hours per Resident per Day
0.82694
Adjusted RN Staffing Hours per Resident per Day
0.77606
Adjusted Total Nurse Staffing Hours per Resident per Day
4.38958
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-03-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2012-12-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2011-12-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
34.66700
Number of Facility Reported Incidents
2
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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