Lutheran Retirement Home - Northwood Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165485
Provider Name
LUTHERAN RETIREMENT HOME
Provider Address
701 NINTH STREET NORTH
NORTHWOOD, IA 50459
NORTHWOOD, IA 50459
Provider Phone Number
(641) 324-1712
Provider SSA County
970
Provider County Name
Worth
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
60
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LUTHERAN RETIREMENT HOME INC.
Date First Approved to Provide Medicare and Medicaid services
2003-05-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
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
3.35000
Reported LPN Staffing Hours per Resident per Day
0.76300
Reported RN Staffing Hours per Resident per Day
0.35500
Reported Licensed Staffing Hours per Resident per Day
1.11800
Reported Total Nurse Staffing Hours per Resident per Day
4.46800
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01700
Expected CNA Staffing Hours per Resident per Day
2.24318
Expected LPN Staffing Hours per Resident per Day
0.50030
Expected RN Staffing Hours per Resident per Day
0.69370
Expected Total Nurse Staffing Hours per Resident per Day
3.43717
Adjusted CNA Staffing Hours per Resident per Day
3.66440
Adjusted LPN Staffing Hours per Resident per Day
1.26582
Adjusted RN Staffing Hours per Resident per Day
0.38238
Adjusted Total Nurse Staffing Hours per Resident per Day
5.23979
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-12-11
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
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
2013-11-07
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-09-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
4.66700
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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