Prairie View Home - Sanborn Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165574
Provider Name
PRAIRIE VIEW HOME
Provider Address
610 EASTERN STREET
SANBORN, IA 51248
SANBORN, IA 51248
Provider Phone Number
(712) 930-3228
Provider SSA County
700
Provider County Name
Obrien
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
73
Number of Residents in Certified Beds
70
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PRAIRIE VIEW LEASING
Date First Approved to Provide Medicare and Medicaid services
2006-10-01
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.85071
Reported LPN Staffing Hours per Resident per Day
0.64571
Reported RN Staffing Hours per Resident per Day
0.35000
Reported Licensed Staffing Hours per Resident per Day
0.99571
Reported Total Nurse Staffing Hours per Resident per Day
3.84642
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.26290
Expected LPN Staffing Hours per Resident per Day
0.58653
Expected RN Staffing Hours per Resident per Day
0.80021
Expected Total Nurse Staffing Hours per Resident per Day
3.64964
Adjusted CNA Staffing Hours per Resident per Day
3.09108
Adjusted LPN Staffing Hours per Resident per Day
0.91374
Adjusted RN Staffing Hours per Resident per Day
0.32681
Adjusted Total Nurse Staffing Hours per Resident per Day
4.24823
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-02-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-11-21
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-09-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
13.33300
Number of Facility Reported Incidents
3
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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