Genesis Medical Center-dewitt - De Witt Nursing Home

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Federal Provider Number
160000000000000000000000000000
Provider Name
GENESIS MEDICAL CENTER-DEWITT
Provider Address
1118 11TH STREET
DE WITT, IA 52742
Provider Phone Number
(563) 659-4210
Provider SSA County
220
Provider County Name
Clinton
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
77
Number of Residents in Certified Beds
73
Provider Type
Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1974-03-31
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
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
2.53082
Reported LPN Staffing Hours per Resident per Day
0.37603
Reported RN Staffing Hours per Resident per Day
0.72534
Reported Licensed Staffing Hours per Resident per Day
1.10137
Reported Total Nurse Staffing Hours per Resident per Day
3.63219
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00205
Expected CNA Staffing Hours per Resident per Day
2.33453
Expected LPN Staffing Hours per Resident per Day
0.52988
Expected RN Staffing Hours per Resident per Day
0.72282
Expected Total Nurse Staffing Hours per Resident per Day
3.58723
Adjusted CNA Staffing Hours per Resident per Day
2.66001
Adjusted LPN Staffing Hours per Resident per Day
0.58901
Adjusted RN Staffing Hours per Resident per Day
0.74981
Adjusted Total Nurse Staffing Hours per Resident per Day
4.08142
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
8
Cycle 1 Standard Survey Health Date
2014-06-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-04-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-03-23
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
8.66700
Number of Facility Reported Incidents
1
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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