Heritage Nursing Home - Bancroft Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165408
Provider Name
HERITAGE NURSING HOME
Provider Address
546 EAST RAMSEY STREET
BANCROFT, IA 50517
BANCROFT, IA 50517
Provider Phone Number
(515) 885-2463
Provider SSA County
540
Provider County Name
Kossuth
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
39
Number of Residents in Certified Beds
28
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
M&D HAMM INC
Date First Approved to Provide Medicare and Medicaid services
1999-04-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.54821
Reported LPN Staffing Hours per Resident per Day
0.43571
Reported RN Staffing Hours per Resident per Day
0.99286
Reported Licensed Staffing Hours per Resident per Day
1.42857
Reported Total Nurse Staffing Hours per Resident per Day
3.97678
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.51069
Expected LPN Staffing Hours per Resident per Day
0.60664
Expected RN Staffing Hours per Resident per Day
0.83802
Expected Total Nurse Staffing Hours per Resident per Day
3.95535
Adjusted CNA Staffing Hours per Resident per Day
2.49037
Adjusted LPN Staffing Hours per Resident per Day
0.59614
Adjusted RN Staffing Hours per Resident per Day
0.88526
Adjusted Total Nurse Staffing Hours per Resident per Day
4.05274
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-01-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2012-12-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2011-12-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
17.33300
Number of Facility Reported Incidents
1
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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