Good Shepherd Health Center - Mason City Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165072
Provider Name
GOOD SHEPHERD HEALTH CENTER
Provider Address
302 SECOND STREET NE
MASON CITY, IA 50401
MASON CITY, IA 50401
Provider Phone Number
(641) 424-1740
Provider SSA County
160
Provider County Name
Cerro Gordo
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
210
Number of Residents in Certified Beds
197
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOOD SHEPHERD GERIATRIC CENTER, INC.
Date First Approved to Provide Medicare and Medicaid services
1968-01-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.60025
Reported LPN Staffing Hours per Resident per Day
0.51777
Reported RN Staffing Hours per Resident per Day
0.49289
Reported Licensed Staffing Hours per Resident per Day
1.01066
Reported Total Nurse Staffing Hours per Resident per Day
3.61091
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02183
Expected CNA Staffing Hours per Resident per Day
2.35777
Expected LPN Staffing Hours per Resident per Day
0.56266
Expected RN Staffing Hours per Resident per Day
0.76504
Expected Total Nurse Staffing Hours per Resident per Day
3.68547
Adjusted CNA Staffing Hours per Resident per Day
2.70604
Adjusted LPN Staffing Hours per Resident per Day
0.76379
Adjusted RN Staffing Hours per Resident per Day
0.48139
Adjusted Total Nurse Staffing Hours per Resident per Day
3.94935
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
115
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
115
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
24
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
24
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
119
Cycle 3 Standard Health Survey Date
2012-04-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
119
Total Weighted Health Survey Score
85.33300
Number of Facility Reported Incidents
6
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
6663
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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