Prairie Ridge Care & Rehabilit - Mediapolis Nursing Home

General Information

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Federal Provider Number
165220
Provider Name
PRAIRIE RIDGE CARE & REHABILIT
Provider Address
608 PRAIRIE STREET
MEDIAPOLIS, IA 52637
Provider Phone Number
(319) 394-3991
Provider SSA County
280
Provider County Name
Des Moines
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
62
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FIVE STAR QUALITY CARE IA LLC
Date First Approved to Provide Medicare and Medicaid services
1994-05-01
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
3
QM Rating Footnote
Staffing Rating
2
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
1.90273
Reported LPN Staffing Hours per Resident per Day
0.61909
Reported RN Staffing Hours per Resident per Day
0.57182
Reported Licensed Staffing Hours per Resident per Day
1.19091
Reported Total Nurse Staffing Hours per Resident per Day
3.09364
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00545
Expected CNA Staffing Hours per Resident per Day
2.47818
Expected LPN Staffing Hours per Resident per Day
0.61311
Expected RN Staffing Hours per Resident per Day
0.91622
Expected Total Nurse Staffing Hours per Resident per Day
4.00750
Adjusted CNA Staffing Hours per Resident per Day
1.88393
Adjusted LPN Staffing Hours per Resident per Day
0.83810
Adjusted RN Staffing Hours per Resident per Day
0.46633
Adjusted Total Nurse Staffing Hours per Resident per Day
3.11170
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-11-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-09-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
24.00000
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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