Risen Son Christian Village - Council Bluffs Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165466
Provider Name
RISEN SON CHRISTIAN VILLAGE
Provider Address
3000 RISEN SON BOULEVARD
COUNCIL BLUFFS, IA 51503
COUNCIL BLUFFS, IA 51503
Provider Phone Number
(712) 366-9655
Provider SSA County
770
Provider County Name
Pottawattamie
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
102
Number of Residents in Certified Beds
96
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
RISEN SON CHRISTIAN VILLAGE
Date First Approved to Provide Medicare and Medicaid services
2002-07-01
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
2
QM Rating Footnote
Staffing Rating
5
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
3.31094
Reported LPN Staffing Hours per Resident per Day
1.36927
Reported RN Staffing Hours per Resident per Day
1.04531
Reported Licensed Staffing Hours per Resident per Day
2.41458
Reported Total Nurse Staffing Hours per Resident per Day
5.72552
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08906
Expected CNA Staffing Hours per Resident per Day
2.54813
Expected LPN Staffing Hours per Resident per Day
0.61868
Expected RN Staffing Hours per Resident per Day
0.99430
Expected Total Nurse Staffing Hours per Resident per Day
4.16111
Adjusted CNA Staffing Hours per Resident per Day
3.18824
Adjusted LPN Staffing Hours per Resident per Day
1.83697
Adjusted RN Staffing Hours per Resident per Day
0.78554
Adjusted Total Nurse Staffing Hours per Resident per Day
5.54636
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
112
Cycle 1 Standard Survey Health Date
2014-12-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
112
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-10-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-10-18
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
34
Cycle 3 Total Health Score
102
Total Weighted Health Survey Score
86.33300
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
6
Number of Fines
1
Total Amount of Fines in Dollars
4388
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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