Iola Living Assistance, Inc - Iola Nursing Home
General Information
UPDATEFederal Provider Number
525487
Provider Name
IOLA LIVING ASSISTANCE, INC
Provider Address
185 CHET KRAUSE DR PO BOX 237
IOLA, WI 54945
IOLA, WI 54945
Provider Phone Number
7154452412
Provider SSA County
670
Provider County Name
Waupaca
Ownership Type
Non profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
38
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
IOLA LIVING ASSISTANCE, INC.
Date First Approved to Provide Medicare and Medicaid services
1992-05-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
3.11842
Reported LPN Staffing Hours per Resident per Day
0.76579
Reported RN Staffing Hours per Resident per Day
0.86184
Reported Licensed Staffing Hours per Resident per Day
1.62763
Reported Total Nurse Staffing Hours per Resident per Day
4.74605
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04737
Expected CNA Staffing Hours per Resident per Day
2.52360
Expected LPN Staffing Hours per Resident per Day
0.53898
Expected RN Staffing Hours per Resident per Day
0.87392
Expected Total Nurse Staffing Hours per Resident per Day
3.93650
Adjusted CNA Staffing Hours per Resident per Day
3.03205
Adjusted LPN Staffing Hours per Resident per Day
1.17928
Adjusted RN Staffing Hours per Resident per Day
0.73687
Adjusted Total Nurse Staffing Hours per Resident per Day
4.85987
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2015-02-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2014-03-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2013-01-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
42.00000
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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