Palo Alto County Hospital - Emmetsburg Nursing Home

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Federal Provider Number
16E668
Provider Name
PALO ALTO COUNTY HOSPITAL
Provider Address
3201 FIRST STREET
EMMETSBURG, IA 50536
Provider Phone Number
(712) 852-5520
Provider SSA County
730
Provider County Name
Palo Alto
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
22
Number of Residents in Certified Beds
22
Provider Type
Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1986-02-05
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
3
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
1.74091
Reported LPN Staffing Hours per Resident per Day
0.59773
Reported RN Staffing Hours per Resident per Day
0.83182
Reported Licensed Staffing Hours per Resident per Day
1.42955
Reported Total Nurse Staffing Hours per Resident per Day
3.17046
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00227
Expected CNA Staffing Hours per Resident per Day
2.01015
Expected LPN Staffing Hours per Resident per Day
0.50250
Expected RN Staffing Hours per Resident per Day
0.69871
Expected Total Nurse Staffing Hours per Resident per Day
3.21136
Adjusted CNA Staffing Hours per Resident per Day
2.12505
Adjusted LPN Staffing Hours per Resident per Day
0.98730
Adjusted RN Staffing Hours per Resident per Day
0.88955
Adjusted Total Nurse Staffing Hours per Resident per Day
3.97956
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-02-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-01-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2011-12-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
30.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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