Methodist Manor Retirement Com - Storm Lake Nursing Home
General Information
UPDATEFederal Provider Number
165359
Provider Name
METHODIST MANOR RETIREMENT COM
Provider Address
1206 WEST FOURTH STREET
STORM LAKE, IA 50588
STORM LAKE, IA 50588
Provider Phone Number
7127321120
Provider SSA County
100
Provider County Name
Buena Vista
Ownership Type
Non profit - Corporation
Number of Certified Beds
93
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
METHODIST MANOR RETIREMENT COMMUNITY
Date First Approved to Provide Medicare and Medicaid services
1997-09-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
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
1.83400
Reported LPN Staffing Hours per Resident per Day
0.29533
Reported RN Staffing Hours per Resident per Day
0.51933
Reported Licensed Staffing Hours per Resident per Day
0.81467
Reported Total Nurse Staffing Hours per Resident per Day
2.64866
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00733
Expected CNA Staffing Hours per Resident per Day
2.30927
Expected LPN Staffing Hours per Resident per Day
0.52430
Expected RN Staffing Hours per Resident per Day
0.72966
Expected Total Nurse Staffing Hours per Resident per Day
3.56322
Adjusted CNA Staffing Hours per Resident per Day
1.94871
Adjusted LPN Staffing Hours per Resident per Day
0.46753
Adjusted RN Staffing Hours per Resident per Day
0.53182
Adjusted Total Nurse Staffing Hours per Resident per Day
2.99630
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-02-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2012-12-19
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2011-12-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
30.00000
Number of Facility Reported Incidents
0
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
North Lake Manor
1325 North Lake Avenue |
STORM LAKE IA 50588 | 1.1 miles away
Good Samaritan Society - Newell
415 West Highway 7 |
NEWELL IA 50568 | 11.6 miles away
Pleasant View Home
410 Spruce Street |
ALBERT CITY IA 50510 | 16.2 miles away
Sioux Care Center
702 Blake Street |
SIOUX RAPIDS IA 50585 | 17.8 miles away
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