Faith Lutheran Home - Osage Nursing Home

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Federal Provider Number
165433
Provider Name
FAITH LUTHERAN HOME
Provider Address
914 DAVIDSON DRIVE
OSAGE, IA 50461
Provider Phone Number
(641) 732-5511
Provider SSA County
650
Provider County Name
Mitchell
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
60
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FAITH LUTHERAN HOME
Date First Approved to Provide Medicare and Medicaid services
2002-06-01
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
3
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
1.70930
Reported LPN Staffing Hours per Resident per Day
0.61628
Reported RN Staffing Hours per Resident per Day
0.77907
Reported Licensed Staffing Hours per Resident per Day
1.39535
Reported Total Nurse Staffing Hours per Resident per Day
3.10465
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.53399
Expected LPN Staffing Hours per Resident per Day
0.56048
Expected RN Staffing Hours per Resident per Day
0.80175
Expected Total Nurse Staffing Hours per Resident per Day
3.89622
Adjusted CNA Staffing Hours per Resident per Day
1.65514
Adjusted LPN Staffing Hours per Resident per Day
0.91263
Adjusted RN Staffing Hours per Resident per Day
0.72607
Adjusted Total Nurse Staffing Hours per Resident per Day
3.21196
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-12-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-10-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-09-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
14.00000
Number of Facility Reported Incidents
0
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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