Ennoble Skilled Nursing And Rehabilitation Center - Dubuque Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165559
Provider Name
ENNOBLE SKILLED NURSING AND REHABILITATION CENTER
Provider Address
2000 PASADENA DRIVE
DUBUQUE, IA 52001
DUBUQUE, IA 52001
Provider Phone Number
(563) 557-1076
Provider SSA County
300
Provider County Name
Dubuque
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
102
Number of Residents in Certified Beds
72
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COVENANT CARE ENNOBLE, LLC
Date First Approved to Provide Medicare and Medicaid services
2005-11-28
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
3
QM Rating Footnote
Staffing Rating
2
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
2.03819
Reported LPN Staffing Hours per Resident per Day
0.34514
Reported RN Staffing Hours per Resident per Day
0.86667
Reported Licensed Staffing Hours per Resident per Day
1.21181
Reported Total Nurse Staffing Hours per Resident per Day
3.25000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10833
Expected CNA Staffing Hours per Resident per Day
2.63852
Expected LPN Staffing Hours per Resident per Day
0.72000
Expected RN Staffing Hours per Resident per Day
1.24888
Expected Total Nurse Staffing Hours per Resident per Day
4.60740
Adjusted CNA Staffing Hours per Resident per Day
1.89542
Adjusted LPN Staffing Hours per Resident per Day
0.39787
Adjusted RN Staffing Hours per Resident per Day
0.51852
Adjusted Total Nurse Staffing Hours per Resident per Day
2.84334
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-07-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
147
Cycle 2 Standard Health Survey Date
2013-05-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
147
Cycle 3 Total Number of Health Deficiencies
24
Cycle 3 Number of Standard Health Deficiencies
23
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
144
Cycle 3 Standard Health Survey Date
2012-02-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
144
Total Weighted Health Survey Score
111.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
24
Number of Fines
1
Total Amount of Fines in Dollars
7450
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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