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Mill Valley Care Center - Bellevue Nursing Home

General Information

UPDATE
Federal Provider Number
165374
Provider Name
MILL VALLEY CARE CENTER
Provider Address
1201 PARK STREET
BELLEVUE, IA 52031
Provider Phone Number
5638725521
Provider SSA County
480
Provider County Name
Jackson
Ownership Type
For profit - Corporation
Number of Certified Beds
68
Number of Residents in Certified Beds
51
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
RIVERVIEW DEVELOPMENT CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1998-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.85882
Reported LPN Staffing Hours per Resident per Day
0.66863
Reported RN Staffing Hours per Resident per Day
0.58824
Reported Licensed Staffing Hours per Resident per Day
1.25686
Reported Total Nurse Staffing Hours per Resident per Day
3.11569
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01961
Expected CNA Staffing Hours per Resident per Day
2.59498
Expected LPN Staffing Hours per Resident per Day
0.66393
Expected RN Staffing Hours per Resident per Day
0.93058
Expected Total Nurse Staffing Hours per Resident per Day
4.18949
Adjusted CNA Staffing Hours per Resident per Day
1.75762
Adjusted LPN Staffing Hours per Resident per Day
0.83587
Adjusted RN Staffing Hours per Resident per Day
0.47232
Adjusted Total Nurse Staffing Hours per Resident per Day
2.99775
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-06-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-04-25
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-04-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
14.66700
Number of Facility Reported Incidents
0
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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