Qhc Mitchellville, Llc - Mitchellville Nursing Home
General Information
UPDATEFederal Provider Number
165264
Provider Name
QHC MITCHELLVILLE, LLC
Provider Address
114 CARTER STREET SW
MITCHELLVILLE, IA 50169
MITCHELLVILLE, IA 50169
Provider Phone Number
(515) 967-3726
Provider SSA County
760
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
65
Number of Residents in Certified Beds
59
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
QHC MITCHELLVILLE LLC
Date First Approved to Provide Medicare and Medicaid services
1996-02-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.02966
Reported LPN Staffing Hours per Resident per Day
0.30424
Reported RN Staffing Hours per Resident per Day
0.66017
Reported Licensed Staffing Hours per Resident per Day
0.96441
Reported Total Nurse Staffing Hours per Resident per Day
2.99407
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01949
Expected CNA Staffing Hours per Resident per Day
2.48658
Expected LPN Staffing Hours per Resident per Day
0.59588
Expected RN Staffing Hours per Resident per Day
0.92878
Expected Total Nurse Staffing Hours per Resident per Day
4.01125
Adjusted CNA Staffing Hours per Resident per Day
2.00282
Adjusted LPN Staffing Hours per Resident per Day
0.42377
Adjusted RN Staffing Hours per Resident per Day
0.53110
Adjusted Total Nurse Staffing Hours per Resident per Day
3.00874
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
20
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
20
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
2013-11-27
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-09-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
11.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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