Great River Klein Center - West Burlington Nursing Home
General Information
UPDATEFederal Provider Number
165110
Provider Name
GREAT RIVER KLEIN CENTER
Provider Address
1221 S GEAR STREET
WEST BURLINGTON, IA 52655
WEST BURLINGTON, IA 52655
Provider Phone Number
3197681000
Provider SSA County
280
Provider County Name
Des Moines
Ownership Type
Non profit - Corporation
Number of Certified Beds
165
Number of Residents in Certified Beds
155
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
GREAT RIVER MEDICAL CENTER
Date First Approved to Provide Medicare and Medicaid services
1977-05-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
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
3.17774
Reported LPN Staffing Hours per Resident per Day
0.57516
Reported RN Staffing Hours per Resident per Day
0.86452
Reported Licensed Staffing Hours per Resident per Day
1.43968
Reported Total Nurse Staffing Hours per Resident per Day
4.61742
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02290
Expected CNA Staffing Hours per Resident per Day
2.26377
Expected LPN Staffing Hours per Resident per Day
0.55195
Expected RN Staffing Hours per Resident per Day
0.78040
Expected Total Nurse Staffing Hours per Resident per Day
3.59612
Adjusted CNA Staffing Hours per Resident per Day
3.44435
Adjusted LPN Staffing Hours per Resident per Day
0.86490
Adjusted RN Staffing Hours per Resident per Day
0.82775
Adjusted Total Nurse Staffing Hours per Resident per Day
5.17568
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-02-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2012-11-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
104
Cycle 3 Standard Health Survey Date
2011-08-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
104
Total Weighted Health Survey Score
34.00000
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
5200
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Blair House
1212 Indian Hills Drive |
BURLINGTON IA 52601 | 1 mile away
Burlington Care Center
2610 South Fifth Street |
BURLINGTON IA 52601 | 4.1 miles away
Danville Care Center
401 S Birch Street |
DANVILLE IA 52623 | 8.5 miles away
Prairie Ridge Care & Rehabilit
608 Prairie Street |
MEDIAPOLIS IA 52637 | 13.4 miles away
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