Jefferson Place - Pella Nursing Home
General Information
UPDATEFederal Provider Number
165598
Provider Name
JEFFERSON PLACE
Provider Address
413 JEFFERSON STREET
PELLA, IA 50219
PELLA, IA 50219
Provider Phone Number
6416204250
Provider SSA County
620
Provider County Name
Marion
Ownership Type
Non profit - Corporation
Number of Certified Beds
36
Number of Residents in Certified Beds
27
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HEARTHSTONE A MINISTRY OF WESLEYLIFE LLC
Date First Approved to Provide Medicare and Medicaid services
2010-03-02
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
1.98704
Reported LPN Staffing Hours per Resident per Day
0.58519
Reported RN Staffing Hours per Resident per Day
1.39444
Reported Licensed Staffing Hours per Resident per Day
1.97963
Reported Total Nurse Staffing Hours per Resident per Day
3.96667
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14259
Expected CNA Staffing Hours per Resident per Day
2.55518
Expected LPN Staffing Hours per Resident per Day
0.67910
Expected RN Staffing Hours per Resident per Day
1.17782
Expected Total Nurse Staffing Hours per Resident per Day
4.41210
Adjusted CNA Staffing Hours per Resident per Day
1.90812
Adjusted LPN Staffing Hours per Resident per Day
0.71522
Adjusted RN Staffing Hours per Resident per Day
0.88463
Adjusted Total Nurse Staffing Hours per Resident per Day
3.62395
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
15
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-03-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-02-19
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-01-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
52.66700
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
Nursiong Homes Nearby
Pella Regional Health Center
404 Jefferson |
PELLA IA 50219 | 0 mile away
The Cottages
1742 Main Street |
PELLA IA 50219 | 1 mile away
Knoxville Rehabilitation Center
606 North Seventh Street |
KNOXVILLE IA 50138 | 11.2 miles away
West Ridge Nursing & Rehab Center
1904 West Howard Street |
KNOXVILLE IA 50138 | 12.6 miles away
Pleasant Care Living Center
909 North State Street |
PLEASANTVILLE IA 50225 | 18.7 miles away
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