Kanawha Community Home, Inc. - Kanawha Nursing Home

General Information

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Federal Provider Number
165467
Provider Name
KANAWHA COMMUNITY HOME, INC.
Provider Address
130 WEST SIXTH STREET
KANAWHA, IA 50447
Provider Phone Number
(641) 762-3302
Provider SSA County
400
Provider County Name
Hancock
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
38
Number of Residents in Certified Beds
21
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
KANAWHA COMMUNITY HOME, INC
Date First Approved to Provide Medicare and Medicaid services
2002-08-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
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
2.41429
Reported LPN Staffing Hours per Resident per Day
0.65000
Reported RN Staffing Hours per Resident per Day
1.24286
Reported Licensed Staffing Hours per Resident per Day
1.89286
Reported Total Nurse Staffing Hours per Resident per Day
4.30715
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03333
Expected CNA Staffing Hours per Resident per Day
2.02191
Expected LPN Staffing Hours per Resident per Day
0.57494
Expected RN Staffing Hours per Resident per Day
0.81026
Expected Total Nurse Staffing Hours per Resident per Day
3.40711
Adjusted CNA Staffing Hours per Resident per Day
2.92987
Adjusted LPN Staffing Hours per Resident per Day
0.93836
Adjusted RN Staffing Hours per Resident per Day
1.14613
Adjusted Total Nurse Staffing Hours per Resident per Day
5.09572
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-08-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-06-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
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
2012-06-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
8.66700
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
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