Ridgecrest Village - Davenport Nursing Home

General Information

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Federal Provider Number
165049
Provider Name
RIDGECREST VILLAGE
Provider Address
4130 NORTHWEST BOULEVARD
DAVENPORT, IA 52806
Provider Phone Number
(563) 391-3430
Provider SSA County
810
Provider County Name
Scott
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
137
Number of Residents in Certified Beds
91
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CHRISTIAN RETIREMENT HOMES, INC.
Date First Approved to Provide Medicare and Medicaid services
1967-03-23
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
4
QM Rating Footnote
Staffing Rating
4
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
2.72637
Reported LPN Staffing Hours per Resident per Day
0.96484
Reported RN Staffing Hours per Resident per Day
0.54505
Reported Licensed Staffing Hours per Resident per Day
1.50989
Reported Total Nurse Staffing Hours per Resident per Day
4.23626
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03791
Expected CNA Staffing Hours per Resident per Day
2.13759
Expected LPN Staffing Hours per Resident per Day
0.50079
Expected RN Staffing Hours per Resident per Day
0.75501
Expected Total Nurse Staffing Hours per Resident per Day
3.39339
Adjusted CNA Staffing Hours per Resident per Day
3.12955
Adjusted LPN Staffing Hours per Resident per Day
1.59911
Adjusted RN Staffing Hours per Resident per Day
0.53941
Adjusted Total Nurse Staffing Hours per Resident per Day
5.03212
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-05-27
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
12
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
147
Cycle 2 Standard Health Survey Date
2013-03-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
147
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-04-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
63.66700
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
5428
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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