Hillcrest Home - Sumner Nursing Home

General Information

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Federal Provider Number
165502
Provider Name
HILLCREST HOME
Provider Address
915 WEST FIRST STREET
SUMNER, IA 50674
Provider Phone Number
(563) 578-8591
Provider SSA County
80
Provider County Name
Bremer
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
71
Number of Residents in Certified Beds
58
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HILLCREST HOME, INC.
Date First Approved to Provide Medicare and Medicaid services
2003-11-04
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
5
Health Inspection Rating Footnote
QM Rating
5
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
3.10086
Reported LPN Staffing Hours per Resident per Day
0.75603
Reported RN Staffing Hours per Resident per Day
0.57328
Reported Licensed Staffing Hours per Resident per Day
1.32931
Reported Total Nurse Staffing Hours per Resident per Day
4.43017
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03190
Expected CNA Staffing Hours per Resident per Day
2.44986
Expected LPN Staffing Hours per Resident per Day
0.58484
Expected RN Staffing Hours per Resident per Day
0.82401
Expected Total Nurse Staffing Hours per Resident per Day
3.85871
Adjusted CNA Staffing Hours per Resident per Day
3.10572
Adjusted LPN Staffing Hours per Resident per Day
1.07296
Adjusted RN Staffing Hours per Resident per Day
0.51984
Adjusted Total Nurse Staffing Hours per Resident per Day
4.62786
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
2014-06-26
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
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-04-18
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-03-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
7.33300
Number of Facility Reported Incidents
0
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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