Montezuma Nursing & Rehab Cent - Montezuma Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165295
Provider Name
MONTEZUMA NURSING & REHAB CENT
Provider Address
316 MEADOW LANE DRIVE PO BOX 790
MONTEZUMA, IA 50171
MONTEZUMA, IA 50171
Provider Phone Number
(641) 623-5497
Provider SSA County
780
Provider County Name
Poweshiek
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
49
Number of Residents in Certified Beds
23
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CARE INITIATIVES INC
Date First Approved to Provide Medicare and Medicaid services
1996-10-01
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
5
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
2.20435
Reported LPN Staffing Hours per Resident per Day
0.47174
Reported RN Staffing Hours per Resident per Day
0.85000
Reported Licensed Staffing Hours per Resident per Day
1.32174
Reported Total Nurse Staffing Hours per Resident per Day
3.52609
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01957
Expected CNA Staffing Hours per Resident per Day
2.44947
Expected LPN Staffing Hours per Resident per Day
0.51946
Expected RN Staffing Hours per Resident per Day
0.72995
Expected Total Nurse Staffing Hours per Resident per Day
3.69888
Adjusted CNA Staffing Hours per Resident per Day
2.20816
Adjusted LPN Staffing Hours per Resident per Day
0.75375
Adjusted RN Staffing Hours per Resident per Day
0.87008
Adjusted Total Nurse Staffing Hours per Resident per Day
3.84260
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
8
Cycle 1 Standard Survey Health Date
2014-07-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-05-02
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-04-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
4.66700
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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