Keota Health Care Center - Keota Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165355
Provider Name
KEOTA HEALTH CARE CENTER
Provider Address
204 NORTH KEOKUK WASHINGTON ROAD
KEOTA, IA 52248
KEOTA, IA 52248
Provider Phone Number
(641) 636-3400
Provider SSA County
530
Provider County Name
Keokuk
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
42
Number of Residents in Certified Beds
25
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1997-08-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
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
1.62600
Reported LPN Staffing Hours per Resident per Day
0.24600
Reported RN Staffing Hours per Resident per Day
1.10200
Reported Licensed Staffing Hours per Resident per Day
1.34800
Reported Total Nurse Staffing Hours per Resident per Day
2.97400
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02600
Expected CNA Staffing Hours per Resident per Day
2.35831
Expected LPN Staffing Hours per Resident per Day
0.60101
Expected RN Staffing Hours per Resident per Day
0.99097
Expected Total Nurse Staffing Hours per Resident per Day
3.95028
Adjusted CNA Staffing Hours per Resident per Day
1.69177
Adjusted LPN Staffing Hours per Resident per Day
0.33973
Adjusted RN Staffing Hours per Resident per Day
0.83092
Adjusted Total Nurse Staffing Hours per Resident per Day
3.03469
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
16
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
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
2013-12-12
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
40
Cycle 3 Standard Health Survey Date
2012-11-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
20.00000
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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