Pleasantview Home - Kalona Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165470
Provider Name
PLEASANTVIEW HOME
Provider Address
811 THIRD STREET
KALONA, IA 52247
KALONA, IA 52247
Provider Phone Number
(319) 656-2421
Provider SSA County
910
Provider County Name
Washington
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
74
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
IOWA MENNONITE BENEVOLENT ASSOCIATION
Date First Approved to Provide Medicare and Medicaid services
2002-09-01
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
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
2.00000
Reported LPN Staffing Hours per Resident per Day
0.57635
Reported RN Staffing Hours per Resident per Day
0.95541
Reported Licensed Staffing Hours per Resident per Day
1.53176
Reported Total Nurse Staffing Hours per Resident per Day
3.53176
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04797
Expected CNA Staffing Hours per Resident per Day
2.40354
Expected LPN Staffing Hours per Resident per Day
0.59844
Expected RN Staffing Hours per Resident per Day
0.83988
Expected Total Nurse Staffing Hours per Resident per Day
3.84186
Adjusted CNA Staffing Hours per Resident per Day
2.04174
Adjusted LPN Staffing Hours per Resident per Day
0.79936
Adjusted RN Staffing Hours per Resident per Day
0.84998
Adjusted Total Nurse Staffing Hours per Resident per Day
3.70554
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-02-05
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
10
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
165
Cycle 2 Standard Health Survey Date
2014-01-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
165
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-11-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
79.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
5
Number of Fines
1
Total Amount of Fines in Dollars
19046
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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