Mental Health Institute - Clarinda Nursing Home

General Information

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Federal Provider Number
16E702
Provider Name
MENTAL HEALTH INSTITUTE
Provider Address
1800 N 16TH STREET
CLARINDA, IA 51632
Provider Phone Number
(712) 542-2161
Provider SSA County
720
Provider County Name
Page
Provider Website
Provider Description
Ownership Type
Government - State
Number of Certified Beds
63
Number of Residents in Certified Beds
19
Provider Type
Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1997-06-17
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.95789
Reported LPN Staffing Hours per Resident per Day
3.69474
Reported RN Staffing Hours per Resident per Day
2.26053
Reported Licensed Staffing Hours per Resident per Day
5.95526
Reported Total Nurse Staffing Hours per Resident per Day
8.91316
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.13088
Expected LPN Staffing Hours per Resident per Day
0.57647
Expected RN Staffing Hours per Resident per Day
0.78559
Expected Total Nurse Staffing Hours per Resident per Day
3.49294
Adjusted CNA Staffing Hours per Resident per Day
3.40600
Adjusted LPN Staffing Hours per Resident per Day
5.31967
Adjusted RN Staffing Hours per Resident per Day
2.15007
Adjusted Total Nurse Staffing Hours per Resident per Day
10.28590
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-10-09
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
5
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
99
Cycle 2 Standard Health Survey Date
2013-08-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
99
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-07-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
60.33300
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
3
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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