Lone Tree Health Care Center - Lone Tree Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165388
Provider Name
LONE TREE HEALTH CARE CENTER
Provider Address
501 EAST PIONEER ROAD
LONE TREE, IA 52755
LONE TREE, IA 52755
Provider Phone Number
(319) 629-4255
Provider SSA County
510
Provider County Name
Johnson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
44
Number of Residents in Certified Beds
32
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LONE TREE HEALTH CARE CENTER INC.
Date First Approved to Provide Medicare and Medicaid services
1998-04-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.09063
Reported LPN Staffing Hours per Resident per Day
0.82344
Reported RN Staffing Hours per Resident per Day
0.55156
Reported Licensed Staffing Hours per Resident per Day
1.37500
Reported Total Nurse Staffing Hours per Resident per Day
4.46563
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03281
Expected CNA Staffing Hours per Resident per Day
2.05410
Expected LPN Staffing Hours per Resident per Day
0.55224
Expected RN Staffing Hours per Resident per Day
0.81833
Expected Total Nurse Staffing Hours per Resident per Day
3.42466
Adjusted CNA Staffing Hours per Resident per Day
3.69187
Adjusted LPN Staffing Hours per Resident per Day
1.23762
Adjusted RN Staffing Hours per Resident per Day
0.50362
Adjusted Total Nurse Staffing Hours per Resident per Day
5.25614
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
8
Cycle 1 Standard Survey Health Date
2014-10-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-08-21
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-07-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
10.66700
Number of Facility Reported Incidents
1
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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