Gowrie Care Center Llc - Gowrie Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165344
Provider Name
GOWRIE CARE CENTER LLC
Provider Address
1808 MAIN STREET
GOWRIE, IA 50543
GOWRIE, IA 50543
Provider Phone Number
(515) 352-3912
Provider SSA County
930
Provider County Name
Webster
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
28
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SIGNATURE PROPERTIES OF GOWRIE, LLC
Date First Approved to Provide Medicare and Medicaid services
1997-07-01
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
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.80179
Reported LPN Staffing Hours per Resident per Day
0.55357
Reported RN Staffing Hours per Resident per Day
0.78214
Reported Licensed Staffing Hours per Resident per Day
1.33571
Reported Total Nurse Staffing Hours per Resident per Day
3.13750
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00536
Expected CNA Staffing Hours per Resident per Day
2.29972
Expected LPN Staffing Hours per Resident per Day
0.61506
Expected RN Staffing Hours per Resident per Day
0.83500
Expected Total Nurse Staffing Hours per Resident per Day
3.74978
Adjusted CNA Staffing Hours per Resident per Day
1.92243
Adjusted LPN Staffing Hours per Resident per Day
0.74702
Adjusted RN Staffing Hours per Resident per Day
0.69990
Adjusted Total Nurse Staffing Hours per Resident per Day
3.37272
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
104
Cycle 1 Standard Survey Health Date
2014-09-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
104
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-07-11
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
34
Cycle 2 Total Health Score
102
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
16
Cycle 3 Number of Complaint Health Deficiencies
8
Cycle 3 Health Deficiency Score
120
Cycle 3 Standard Health Survey Date
2012-06-29
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
60
Cycle 3 Total Health Score
180
Total Weighted Health Survey Score
116.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
Number of Fines
2
Total Amount of Fines in Dollars
4550
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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