Mill-pond Retirement Community - Ankeny Nursing Home
General Information
UPDATEFederal Provider Number
165261
Provider Name
MILL-POND RETIREMENT COMMUNITY
Provider Address
1201 SE MILL POND COURT
ANKENY, IA 50021
ANKENY, IA 50021
Provider Phone Number
(515) 964-2273
Provider SSA County
760
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
53
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PRESBYTERIAN HOMES MILL POND CARE CENTER INC
Date First Approved to Provide Medicare and Medicaid services
1995-09-19
Continuing Care Retirement Community
Y
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.49057
Reported LPN Staffing Hours per Resident per Day
0.42453
Reported RN Staffing Hours per Resident per Day
1.12547
Reported Licensed Staffing Hours per Resident per Day
1.55000
Reported Total Nurse Staffing Hours per Resident per Day
4.04057
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08113
Expected CNA Staffing Hours per Resident per Day
2.57224
Expected LPN Staffing Hours per Resident per Day
0.59466
Expected RN Staffing Hours per Resident per Day
0.96246
Expected Total Nurse Staffing Hours per Resident per Day
4.12937
Adjusted CNA Staffing Hours per Resident per Day
2.37579
Adjusted LPN Staffing Hours per Resident per Day
0.59254
Adjusted RN Staffing Hours per Resident per Day
0.87375
Adjusted Total Nurse Staffing Hours per Resident per Day
3.94422
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
8
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-07-24
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
28
Cycle 1 Total Health Score
84
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-05-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2012-05-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
65.33300
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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