Friendship Home Association - Audubon Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165232
Provider Name
FRIENDSHIP HOME ASSOCIATION
Provider Address
714 DIVISION
AUDUBON, IA 50025
AUDUBON, IA 50025
Provider Phone Number
(712) 563-2651
Provider SSA County
40
Provider County Name
Audubon
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
64
Number of Residents in Certified Beds
59
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FRIENDSHIP HOME ASSOCIATION
Date First Approved to Provide Medicare and Medicaid services
1994-10-03
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
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.91017
Reported LPN Staffing Hours per Resident per Day
0.88051
Reported RN Staffing Hours per Resident per Day
0.50424
Reported Licensed Staffing Hours per Resident per Day
1.38475
Reported Total Nurse Staffing Hours per Resident per Day
5.29492
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00847
Expected CNA Staffing Hours per Resident per Day
2.10444
Expected LPN Staffing Hours per Resident per Day
0.56816
Expected RN Staffing Hours per Resident per Day
0.82928
Expected Total Nurse Staffing Hours per Resident per Day
3.50189
Adjusted CNA Staffing Hours per Resident per Day
4.55911
Adjusted LPN Staffing Hours per Resident per Day
1.28630
Adjusted RN Staffing Hours per Resident per Day
0.45433
Adjusted Total Nurse Staffing Hours per Resident per Day
6.09479
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
16
Cycle 1 Standard Survey Health Date
2015-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-09-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
28.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
4
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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