Luther Manor Retirement Home - Dubuque Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165513
Provider Name
LUTHER MANOR RETIREMENT HOME
Provider Address
3131 HILLCREST ROAD
DUBUQUE, IA 52001
DUBUQUE, IA 52001
Provider Phone Number
(563) 588-1413
Provider SSA County
300
Provider County Name
Dubuque
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
103
Number of Residents in Certified Beds
100
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MARTIN LUTHER HOME CORPORATION
Date First Approved to Provide Medicare and Medicaid services
2004-03-01
Continuing Care Retirement Community
Y
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.83000
Reported LPN Staffing Hours per Resident per Day
0.48700
Reported RN Staffing Hours per Resident per Day
0.46250
Reported Licensed Staffing Hours per Resident per Day
0.94950
Reported Total Nurse Staffing Hours per Resident per Day
3.77950
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04950
Expected CNA Staffing Hours per Resident per Day
2.58317
Expected LPN Staffing Hours per Resident per Day
0.56402
Expected RN Staffing Hours per Resident per Day
0.80109
Expected Total Nurse Staffing Hours per Resident per Day
3.94828
Adjusted CNA Staffing Hours per Resident per Day
2.68816
Adjusted LPN Staffing Hours per Resident per Day
0.71666
Adjusted RN Staffing Hours per Resident per Day
0.43139
Adjusted Total Nurse Staffing Hours per Resident per Day
3.85859
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-09-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2013-10-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-09-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
40.66700
Number of Facility Reported Incidents
2
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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