Mercy Medical Center-dubuque - Dyersville Nursing Home

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Federal Provider Number
16E638
Provider Name
MERCY MEDICAL CENTER-DUBUQUE
Provider Address
1111 THIRD STREET SW
DYERSVILLE, IA 52040
Provider Phone Number
(563) 875-2921
Provider SSA County
300
Provider County Name
Dubuque
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
40
Number of Residents in Certified Beds
36
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
1986-10-31
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
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
2.75972
Reported LPN Staffing Hours per Resident per Day
0.23472
Reported RN Staffing Hours per Resident per Day
1.22917
Reported Licensed Staffing Hours per Resident per Day
1.46389
Reported Total Nurse Staffing Hours per Resident per Day
4.22361
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00556
Expected CNA Staffing Hours per Resident per Day
2.15239
Expected LPN Staffing Hours per Resident per Day
0.49243
Expected RN Staffing Hours per Resident per Day
0.66869
Expected Total Nurse Staffing Hours per Resident per Day
3.31351
Adjusted CNA Staffing Hours per Resident per Day
3.14605
Adjusted LPN Staffing Hours per Resident per Day
0.39562
Adjusted RN Staffing Hours per Resident per Day
1.37348
Adjusted Total Nurse Staffing Hours per Resident per Day
5.13804
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-01-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-10-23
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-08-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
22.00000
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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