Hallmark Care Center - Sioux City Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165435
Provider Name
HALLMARK CARE CENTER
Provider Address
3800 INDIAN HILLS DRIVE
SIOUX CITY, IA 51104
SIOUX CITY, IA 51104
Provider Phone Number
(712) 239-5025
Provider SSA County
960
Provider County Name
Woodbury
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
48
Number of Residents in Certified Beds
41
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HALLMARK CARE LLC
Date First Approved to Provide Medicare and Medicaid services
2001-01-01
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
1
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
1.96707
Reported LPN Staffing Hours per Resident per Day
0.77317
Reported RN Staffing Hours per Resident per Day
0.65488
Reported Licensed Staffing Hours per Resident per Day
1.42805
Reported Total Nurse Staffing Hours per Resident per Day
3.39512
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04878
Expected CNA Staffing Hours per Resident per Day
2.28830
Expected LPN Staffing Hours per Resident per Day
0.65452
Expected RN Staffing Hours per Resident per Day
1.02259
Expected Total Nurse Staffing Hours per Resident per Day
3.96541
Adjusted CNA Staffing Hours per Resident per Day
2.10925
Adjusted LPN Staffing Hours per Resident per Day
0.98046
Adjusted RN Staffing Hours per Resident per Day
0.47851
Adjusted Total Nurse Staffing Hours per Resident per Day
3.45119
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
15
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2015-02-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
20
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
14
Cycle 2 Health Deficiency Score
124
Cycle 2 Standard Health Survey Date
2014-01-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
124
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-10-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
82.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
16
Number of Fines
1
Total Amount of Fines in Dollars
4800
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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