On With Life - Ankeny Nursing Home
General Information
UPDATEFederal Provider Number
165163
Provider Name
ON WITH LIFE
Provider Address
715 SW ANKENY ROAD
ANKENY, IA 50023
ANKENY, IA 50023
Provider Phone Number
(515) 965-1339
Provider SSA County
760
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
26
Number of Residents in Certified Beds
23
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ON WITH LIFE, INC.
Date First Approved to Provide Medicare and Medicaid services
1991-08-20
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
5
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
0
Staffing Rating Footnote
Data Not Available
RN Staffing Rating
0
RN Staffing Rating Footnote
Data Not Available
Reported Staffing Footnote
Staffing Values not Reported because of Data Quality Concerns
Physical Therapist Staffing Footnote
Physical Therapy Staffing Values not Reported because of Data Quality Concerns
Reported CNA Staffing Hours per Resident per Day
0.00000
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
0.00000
Reported Licensed Staffing Hours per Resident per Day
0.00000
Reported Total Nurse Staffing Hours per Resident per Day
0.00000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.49540
Expected LPN Staffing Hours per Resident per Day
0.72140
Expected RN Staffing Hours per Resident per Day
1.51415
Expected Total Nurse Staffing Hours per Resident per Day
4.73095
Adjusted CNA Staffing Hours per Resident per Day
0.00000
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.00000
Adjusted Total Nurse Staffing Hours per Resident per Day
0.00000
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
4
Cycle 1 Standard Survey Health Date
2014-05-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-04-04
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-04-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
8.66700
Number of Facility Reported Incidents
1
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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