Lake Park Care Center - Lake Park Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165445
Provider Name
LAKE PARK CARE CENTER
Provider Address
1304 SOUTH MARKET
LAKE PARK, IA 51347
LAKE PARK, IA 51347
Provider Phone Number
(712) 832-3691
Provider SSA County
290
Provider County Name
Dickinson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
46
Number of Residents in Certified Beds
22
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SIGNATURE PROPERTIES OF LAKE PARK, LLC
Date First Approved to Provide Medicare and Medicaid services
2002-05-18
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
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
1.84091
Reported LPN Staffing Hours per Resident per Day
0.43864
Reported RN Staffing Hours per Resident per Day
1.20000
Reported Licensed Staffing Hours per Resident per Day
1.63864
Reported Total Nurse Staffing Hours per Resident per Day
3.47955
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04545
Expected CNA Staffing Hours per Resident per Day
2.33947
Expected LPN Staffing Hours per Resident per Day
0.57484
Expected RN Staffing Hours per Resident per Day
0.83925
Expected Total Nurse Staffing Hours per Resident per Day
3.75356
Adjusted CNA Staffing Hours per Resident per Day
1.93079
Adjusted LPN Staffing Hours per Resident per Day
0.63335
Adjusted RN Staffing Hours per Resident per Day
1.06839
Adjusted Total Nurse Staffing Hours per Resident per Day
3.73665
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-04-24
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
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-03-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-02-24
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
51.33300
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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