Iowa Masonic Health Facilities - Bettendorf Nursing Home

General Information

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Federal Provider Number
165553
Provider Name
IOWA MASONIC HEALTH FACILITIES
Provider Address
2500 GRANT STREET
BETTENDORF, IA 52722
Provider Phone Number
(563) 359-9171
Provider SSA County
810
Provider County Name
Scott
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
79
Number of Residents in Certified Beds
67
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BOARD OF TRUSTEES GRAND CHARITY FUNDS IOWA MASONIC NURSING HOME
Date First Approved to Provide Medicare and Medicaid services
2004-10-01
Continuing Care Retirement Community
Y
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
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
3.61045
Reported LPN Staffing Hours per Resident per Day
0.69701
Reported RN Staffing Hours per Resident per Day
1.03284
Reported Licensed Staffing Hours per Resident per Day
1.72985
Reported Total Nurse Staffing Hours per Resident per Day
5.34030
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03284
Expected CNA Staffing Hours per Resident per Day
2.43178
Expected LPN Staffing Hours per Resident per Day
0.53273
Expected RN Staffing Hours per Resident per Day
0.80634
Expected Total Nurse Staffing Hours per Resident per Day
3.77084
Adjusted CNA Staffing Hours per Resident per Day
3.64300
Adjusted LPN Staffing Hours per Resident per Day
1.08596
Adjusted RN Staffing Hours per Resident per Day
0.95709
Adjusted Total Nurse Staffing Hours per Resident per Day
5.70860
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-11-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-09-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-09-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
30.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
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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