Halcyon House - Washington Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165483
Provider Name
HALCYON HOUSE
Provider Address
1015 SOUTH IOWA AVENUE
WASHINGTON, IA 52353
WASHINGTON, IA 52353
Provider Phone Number
(319) 653-7264
Provider SSA County
910
Provider County Name
Washington
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
37
Number of Residents in Certified Beds
33
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WESLEY RETIREMENT SERVICES INC
Date First Approved to Provide Medicare and Medicaid services
2003-04-01
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
4.52424
Reported LPN Staffing Hours per Resident per Day
0.51364
Reported RN Staffing Hours per Resident per Day
1.56667
Reported Licensed Staffing Hours per Resident per Day
2.08030
Reported Total Nurse Staffing Hours per Resident per Day
6.60455
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03182
Expected CNA Staffing Hours per Resident per Day
2.50654
Expected LPN Staffing Hours per Resident per Day
0.52627
Expected RN Staffing Hours per Resident per Day
0.75645
Expected Total Nurse Staffing Hours per Resident per Day
3.78926
Adjusted CNA Staffing Hours per Resident per Day
4.42886
Adjusted LPN Staffing Hours per Resident per Day
0.81009
Adjusted RN Staffing Hours per Resident per Day
1.54752
Adjusted Total Nurse Staffing Hours per Resident per Day
7.02573
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-10-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-08-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-08-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
22.66700
Number of Facility Reported Incidents
3
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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