Manorcare Health Services - Waterloo Nursing Home

General Information

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Federal Provider Number
165034
Provider Name
MANORCARE HEALTH SERVICES
Provider Address
201 WEST RIDGEWAY AVENUE
WATERLOO, IA 50701
Provider Phone Number
(319) 234-7777
Provider SSA County
60
Provider County Name
Black Hawk
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
97
Number of Residents in Certified Beds
71
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MANOR CARE OF WATERLOO IA LLC
Date First Approved to Provide Medicare and Medicaid services
1967-01-19
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
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
1.74014
Reported LPN Staffing Hours per Resident per Day
0.69155
Reported RN Staffing Hours per Resident per Day
0.90352
Reported Licensed Staffing Hours per Resident per Day
1.59507
Reported Total Nurse Staffing Hours per Resident per Day
3.33521
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14155
Expected CNA Staffing Hours per Resident per Day
2.50421
Expected LPN Staffing Hours per Resident per Day
0.79320
Expected RN Staffing Hours per Resident per Day
1.54831
Expected Total Nurse Staffing Hours per Resident per Day
4.84572
Adjusted CNA Staffing Hours per Resident per Day
1.70504
Adjusted LPN Staffing Hours per Resident per Day
0.72363
Adjusted RN Staffing Hours per Resident per Day
0.43603
Adjusted Total Nurse Staffing Hours per Resident per Day
2.77439
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
40
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
40
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
12
Cycle 2 Health Deficiency Score
132
Cycle 2 Standard Health Survey Date
2013-08-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
132
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
9
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-07-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
74.66700
Number of Facility Reported Incidents
7
Number of Substantiated Complaints
17
Number of Fines
1
Total Amount of Fines in Dollars
1170
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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