Grand Ji Vante - Ackley Nursing Home

General Information

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Federal Provider Number
165443
Provider Name
GRAND JI VANTE
Provider Address
502 BUTLER STREET
ACKLEY, IA 50601
Provider Phone Number
(641) 847-3531
Provider SSA County
410
Provider County Name
Hardin
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
70
Number of Residents in Certified Beds
46
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PRESBYTERIAN VILLAGE
Date First Approved to Provide Medicare and Medicaid services
2002-01-01
Continuing Care Retirement Community
Y
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
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.71848
Reported LPN Staffing Hours per Resident per Day
0.66522
Reported RN Staffing Hours per Resident per Day
0.31304
Reported Licensed Staffing Hours per Resident per Day
0.97826
Reported Total Nurse Staffing Hours per Resident per Day
3.69674
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08043
Expected CNA Staffing Hours per Resident per Day
2.15025
Expected LPN Staffing Hours per Resident per Day
0.56033
Expected RN Staffing Hours per Resident per Day
0.76400
Expected Total Nurse Staffing Hours per Resident per Day
3.47458
Adjusted CNA Staffing Hours per Resident per Day
3.10212
Adjusted LPN Staffing Hours per Resident per Day
0.98536
Adjusted RN Staffing Hours per Resident per Day
0.30616
Adjusted Total Nurse Staffing Hours per Resident per Day
4.28863
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
13
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
169
Cycle 2 Standard Health Survey Date
2014-01-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
169
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-11-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
109.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
10
Number of Fines
2
Total Amount of Fines in Dollars
15738
Number of Payment Denials
2
Total Number of Penalties
4
Location
Processing Date
2015-06-01
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