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Hiawatha Care Center - Hiawatha Nursing Home

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Federal Provider Number
165537
Provider Name
HIAWATHA CARE CENTER
Provider Address
405 NORTH 15TH AVENUE
HIAWATHA, IA 52233
Provider Phone Number
(319) 378-8583
Provider SSA County
560
Provider County Name
Linn
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
109
Number of Residents in Certified Beds
101
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HIAWATHA CARE CENTER INC
Date First Approved to Provide Medicare and Medicaid services
2004-04-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.59752
Reported LPN Staffing Hours per Resident per Day
0.53465
Reported RN Staffing Hours per Resident per Day
0.83911
Reported Licensed Staffing Hours per Resident per Day
1.37376
Reported Total Nurse Staffing Hours per Resident per Day
3.97128
Reported Physical Therapist Staffing Hours per Resident Per Day
0.21733
Expected CNA Staffing Hours per Resident per Day
2.43298
Expected LPN Staffing Hours per Resident per Day
0.62350
Expected RN Staffing Hours per Resident per Day
1.09051
Expected Total Nurse Staffing Hours per Resident per Day
4.14699
Adjusted CNA Staffing Hours per Resident per Day
2.61964
Adjusted LPN Staffing Hours per Resident per Day
0.71173
Adjusted RN Staffing Hours per Resident per Day
0.57494
Adjusted Total Nurse Staffing Hours per Resident per Day
3.86011
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-09-18
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
9
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
131
Cycle 2 Standard Health Survey Date
2013-07-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
131
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-06-28
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
53.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
8
Number of Fines
1
Total Amount of Fines in Dollars
7250
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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