Qhc Fort Dodge Villa , Llc - Fort Dodge Nursing Home
General Information
UPDATEFederal Provider Number
165265
Provider Name
QHC FORT DODGE VILLA , LLC
Provider Address
2721 10TH AVENUE NORTH
FORT DODGE, IA 50501
FORT DODGE, IA 50501
Provider Phone Number
5155767525
Provider SSA County
930
Provider County Name
Webster
Ownership Type
For profit - Corporation
Number of Certified Beds
107
Number of Residents in Certified Beds
88
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
QHC FORT DODGE VILLA, LLC
Date First Approved to Provide Medicare and Medicaid services
1996-01-01
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
2
QM Rating Footnote
Staffing Rating
3
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
1.88239
Reported LPN Staffing Hours per Resident per Day
0.27955
Reported RN Staffing Hours per Resident per Day
0.99261
Reported Licensed Staffing Hours per Resident per Day
1.27216
Reported Total Nurse Staffing Hours per Resident per Day
3.15455
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03068
Expected CNA Staffing Hours per Resident per Day
2.34355
Expected LPN Staffing Hours per Resident per Day
0.62398
Expected RN Staffing Hours per Resident per Day
0.98213
Expected Total Nurse Staffing Hours per Resident per Day
3.94967
Adjusted CNA Staffing Hours per Resident per Day
1.97086
Adjusted LPN Staffing Hours per Resident per Day
0.37185
Adjusted RN Staffing Hours per Resident per Day
0.75517
Adjusted Total Nurse Staffing Hours per Resident per Day
3.21943
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
4
Cycle 1 Standard Survey Health Date
2014-12-11
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
8
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-10-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-08-24
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
25.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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
Nursiong Homes Nearby
Marian Home
2400 Sixth Avenue North |
FORT DODGE IA 50501 | 0.3 mile away
Fort Dodge Health And Rehabilitation
728 14th Avenue North |
FORT DODGE IA 50501 | 1.7 miles away
Friendship Haven, Inc
420 South Kenyon Road |
FORT DODGE IA 50501 | 2.6 miles away
Gowrie Care Center Llc
1808 Main Street |
GOWRIE IA 50543 | 17.5 miles away
Grandview Health Care Center
508 2nd Street Ne |
DAYTON IA 50530 | 17.8 miles away
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