Embassy Healthcare Community - Sergeant Bluff Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165145
Provider Name
EMBASSY HEALTHCARE COMMUNITY
Provider Address
206 PORT NEAL ROAD
SERGEANT BLUFF, IA 51054
SERGEANT BLUFF, IA 51054
Provider Phone Number
(712) 943-3837
Provider SSA County
960
Provider County Name
Woodbury
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
53
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SERGEANT BLUFF HEALTHCARE LLC
Date First Approved to Provide Medicare and Medicaid services
1988-11-28
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.90283
Reported LPN Staffing Hours per Resident per Day
0.48868
Reported RN Staffing Hours per Resident per Day
0.88113
Reported Licensed Staffing Hours per Resident per Day
1.36981
Reported Total Nurse Staffing Hours per Resident per Day
3.27264
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02925
Expected CNA Staffing Hours per Resident per Day
2.42943
Expected LPN Staffing Hours per Resident per Day
0.58509
Expected RN Staffing Hours per Resident per Day
0.93482
Expected Total Nurse Staffing Hours per Resident per Day
3.94933
Adjusted CNA Staffing Hours per Resident per Day
1.92184
Adjusted LPN Staffing Hours per Resident per Day
0.69323
Adjusted RN Staffing Hours per Resident per Day
0.70429
Adjusted Total Nurse Staffing Hours per Resident per Day
3.34023
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
116
Cycle 1 Standard Survey Health Date
2014-05-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
116
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-03-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-03-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
76.00000
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
6
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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