Lakeside Lutheran Home - Emmetsburg Nursing Home

General Information

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Federal Provider Number
165492
Provider Name
LAKESIDE LUTHERAN HOME
Provider Address
301 NORTH LAWLER STREET
EMMETSBURG, IA 50536
Provider Phone Number
(712) 852-4060
Provider SSA County
730
Provider County Name
Palo Alto
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
60
Number of Residents in Certified Beds
53
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LAKESIDE LUTHERAN HOME
Date First Approved to Provide Medicare and Medicaid services
2003-11-06
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
2
QM Rating Footnote
Staffing Rating
4
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
2.60189
Reported LPN Staffing Hours per Resident per Day
0.34906
Reported RN Staffing Hours per Resident per Day
0.59340
Reported Licensed Staffing Hours per Resident per Day
0.94245
Reported Total Nurse Staffing Hours per Resident per Day
3.54435
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02170
Expected CNA Staffing Hours per Resident per Day
2.32418
Expected LPN Staffing Hours per Resident per Day
0.54866
Expected RN Staffing Hours per Resident per Day
0.76607
Expected Total Nurse Staffing Hours per Resident per Day
3.63891
Adjusted CNA Staffing Hours per Resident per Day
2.74689
Adjusted LPN Staffing Hours per Resident per Day
0.52805
Adjusted RN Staffing Hours per Resident per Day
0.57878
Adjusted Total Nurse Staffing Hours per Resident per Day
3.92615
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-01-31
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-01-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
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
28
Cycle 3 Standard Health Survey Date
2011-12-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
52.00000
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
1
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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