Highland Ridge Care Center, Llc - Williamsburg Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165566
Provider Name
HIGHLAND RIDGE CARE CENTER, LLC
Provider Address
102 HIGHLAND CIRCLE
WILLIAMSBURG, IA 52361
WILLIAMSBURG, IA 52361
Provider Phone Number
(319) 668-3800
Provider SSA County
470
Provider County Name
Iowa
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
59
Number of Residents in Certified Beds
59
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HIGHLAND RIDGE CARE CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
2006-01-24
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
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
3.50508
Reported LPN Staffing Hours per Resident per Day
0.33983
Reported RN Staffing Hours per Resident per Day
0.74746
Reported Licensed Staffing Hours per Resident per Day
1.08729
Reported Total Nurse Staffing Hours per Resident per Day
4.59237
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01102
Expected CNA Staffing Hours per Resident per Day
2.21844
Expected LPN Staffing Hours per Resident per Day
0.53868
Expected RN Staffing Hours per Resident per Day
0.75530
Expected Total Nurse Staffing Hours per Resident per Day
3.51242
Adjusted CNA Staffing Hours per Resident per Day
3.87679
Adjusted LPN Staffing Hours per Resident per Day
0.52361
Adjusted RN Staffing Hours per Resident per Day
0.73944
Adjusted Total Nurse Staffing Hours per Resident per Day
5.27027
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-12-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-10-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-08-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
25.33300
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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