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Kingsley Nursing & Rehab Cente - Kingsley Nursing Home

General Information

UPDATE
Federal Provider Number
165329
Provider Name
KINGSLEY NURSING & REHAB CENTE
Provider Address
305 WEST THIRD BOX 10
KINGSLEY, IA 51028
Provider Phone Number
7123782400
Provider SSA County
740
Provider County Name
Plymouth
Ownership Type
Non profit - Corporation
Number of Certified Beds
43
Number of Residents in Certified Beds
38
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CARE INITIATIVES INC
Date First Approved to Provide Medicare and Medicaid services
1997-09-08
Continuing Care Retirement Community
N
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
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.04474
Reported LPN Staffing Hours per Resident per Day
0.31184
Reported RN Staffing Hours per Resident per Day
0.75921
Reported Licensed Staffing Hours per Resident per Day
1.07105
Reported Total Nurse Staffing Hours per Resident per Day
3.11579
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01447
Expected CNA Staffing Hours per Resident per Day
2.31288
Expected LPN Staffing Hours per Resident per Day
0.56047
Expected RN Staffing Hours per Resident per Day
0.84117
Expected Total Nurse Staffing Hours per Resident per Day
3.71453
Adjusted CNA Staffing Hours per Resident per Day
2.16923
Adjusted LPN Staffing Hours per Resident per Day
0.46180
Adjusted RN Staffing Hours per Resident per Day
0.67439
Adjusted Total Nurse Staffing Hours per Resident per Day
3.38117
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-07-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
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
2013-05-23
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
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
2012-05-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
28.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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