Maple Crest Manor - Fayette Nursing Home
General Information
UPDATEFederal Provider Number
165437
Provider Name
MAPLE CREST MANOR
Provider Address
100 BOLGER DRIVE
FAYETTE, IA 52142
FAYETTE, IA 52142
Provider Phone Number
5634253336
Provider SSA County
320
Provider County Name
Fayette
Ownership Type
For profit - Corporation
Number of Certified Beds
55
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COLONIAL MANORS OF FAYETTE, INC
Date First Approved to Provide Medicare and Medicaid services
2001-04-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
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
2.15700
Reported LPN Staffing Hours per Resident per Day
0.64200
Reported RN Staffing Hours per Resident per Day
0.71900
Reported Licensed Staffing Hours per Resident per Day
1.36100
Reported Total Nurse Staffing Hours per Resident per Day
3.51800
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01600
Expected CNA Staffing Hours per Resident per Day
2.39462
Expected LPN Staffing Hours per Resident per Day
0.54998
Expected RN Staffing Hours per Resident per Day
0.81099
Expected Total Nurse Staffing Hours per Resident per Day
3.75559
Adjusted CNA Staffing Hours per Resident per Day
2.21021
Adjusted LPN Staffing Hours per Resident per Day
0.96888
Adjusted RN Staffing Hours per Resident per Day
0.66244
Adjusted Total Nurse Staffing Hours per Resident per Day
3.77589
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-10-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-07-03
Cycle 2 Number of Health Revisits
1
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
1
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-06-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
25.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
2
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
Nursiong Homes Nearby
Good Samaritan Society - West Union
201 Hall Street |
WEST UNION IA 52175 | 8.9 miles away
Mercy Hospital Of The Franciscan Sisters
201 Eighth Avenue Se |
OELWEIN IA 50662 | 12.4 miles away
Grandview Healthcare Center
800 Fifth Street Se |
OELWEIN IA 50662 | 12.7 miles away
Oelwein Health Care Center
600 Seventh Street Se |
OELWEIN IA 50662 | 12.9 miles away
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