Northcrest Specialty Care - Waterloo Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165165
Provider Name
NORTHCREST SPECIALTY CARE
Provider Address
2001 HEATH STREET
WATERLOO, IA 50703
WATERLOO, IA 50703
Provider Phone Number
(319) 234-4423
Provider SSA County
60
Provider County Name
Black Hawk
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
94
Number of Residents in Certified Beds
82
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
1992-02-01
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
2
QM Rating Footnote
Staffing Rating
3
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
2.24207
Reported LPN Staffing Hours per Resident per Day
0.75427
Reported RN Staffing Hours per Resident per Day
0.62805
Reported Licensed Staffing Hours per Resident per Day
1.38232
Reported Total Nurse Staffing Hours per Resident per Day
3.62439
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08598
Expected CNA Staffing Hours per Resident per Day
2.42589
Expected LPN Staffing Hours per Resident per Day
0.62208
Expected RN Staffing Hours per Resident per Day
1.01836
Expected Total Nurse Staffing Hours per Resident per Day
4.06632
Adjusted CNA Staffing Hours per Resident per Day
2.26778
Adjusted LPN Staffing Hours per Resident per Day
1.00637
Adjusted RN Staffing Hours per Resident per Day
0.46082
Adjusted Total Nurse Staffing Hours per Resident per Day
3.59282
Cycle 1 Total Number of Health Deficiencies
2
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
2014-11-25
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
7
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-09-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
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
22.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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