Iowa Jewish Senior Life Center - Des Moines Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165006
Provider Name
IOWA JEWISH SENIOR LIFE CENTER
Provider Address
900 POLK BOULEVARD
DES MOINES, IA 50312
DES MOINES, IA 50312
Provider Phone Number
(515) 255-5433
Provider SSA County
760
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
72
Number of Residents in Certified Beds
52
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
IOWA JEWISH SENIOR LIFE CENTER
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
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
4.85096
Reported LPN Staffing Hours per Resident per Day
0.97115
Reported RN Staffing Hours per Resident per Day
1.07404
Reported Licensed Staffing Hours per Resident per Day
2.04519
Reported Total Nurse Staffing Hours per Resident per Day
6.89615
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05192
Expected CNA Staffing Hours per Resident per Day
2.53316
Expected LPN Staffing Hours per Resident per Day
0.59989
Expected RN Staffing Hours per Resident per Day
0.88424
Expected Total Nurse Staffing Hours per Resident per Day
4.01729
Adjusted CNA Staffing Hours per Resident per Day
4.69880
Adjusted LPN Staffing Hours per Resident per Day
1.34366
Adjusted RN Staffing Hours per Resident per Day
0.90759
Adjusted Total Nurse Staffing Hours per Resident per Day
6.91951
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-09-04
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
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
2013-08-15
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
8
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
159
Cycle 3 Standard Health Survey Date
2012-07-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
159
Total Weighted Health Survey Score
32.50000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
Number of Fines
1
Total Amount of Fines in Dollars
5395
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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