Odebolt Nursing & Rehab Center - Odebolt Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165180
Provider Name
ODEBOLT NURSING & REHAB CENTER
Provider Address
801 SOUTH DES MOINES STREET
ODEBOLT, IA 51458
ODEBOLT, IA 51458
Provider Phone Number
(712) 668-4867
Provider SSA County
800
Provider County Name
Sac
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
46
Number of Residents in Certified Beds
27
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
1992-12-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.11296
Reported LPN Staffing Hours per Resident per Day
0.71296
Reported RN Staffing Hours per Resident per Day
0.65000
Reported Licensed Staffing Hours per Resident per Day
1.36296
Reported Total Nurse Staffing Hours per Resident per Day
3.47592
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01852
Expected CNA Staffing Hours per Resident per Day
2.44322
Expected LPN Staffing Hours per Resident per Day
0.57424
Expected RN Staffing Hours per Resident per Day
0.93080
Expected Total Nurse Staffing Hours per Resident per Day
3.94826
Adjusted CNA Staffing Hours per Resident per Day
2.12202
Adjusted LPN Staffing Hours per Resident per Day
1.03050
Adjusted RN Staffing Hours per Resident per Day
0.52179
Adjusted Total Nurse Staffing Hours per Resident per Day
3.54867
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
2014-03-20
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
5
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-01-24
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
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2011-12-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
27.33300
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
3
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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