Riverside South - Ames Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165422
Provider Name
RIVERSIDE SOUTH
Provider Address
1204 SOUTH FOURTH STREET
AMES, IA 50010
AMES, IA 50010
Provider Phone Number
(515) 233-2903
Provider SSA County
840
Provider County Name
Story
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
59
Number of Residents in Certified Beds
40
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
RIVERSIDE MANOR LLC
Date First Approved to Provide Medicare and Medicaid services
2001-07-05
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
3
Health Inspection Rating Footnote
QM Rating
5
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
1.50250
Reported LPN Staffing Hours per Resident per Day
0.46625
Reported RN Staffing Hours per Resident per Day
0.81625
Reported Licensed Staffing Hours per Resident per Day
1.28250
Reported Total Nurse Staffing Hours per Resident per Day
2.78500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14250
Expected CNA Staffing Hours per Resident per Day
2.29415
Expected LPN Staffing Hours per Resident per Day
0.64036
Expected RN Staffing Hours per Resident per Day
1.03162
Expected Total Nurse Staffing Hours per Resident per Day
3.96613
Adjusted CNA Staffing Hours per Resident per Day
1.60700
Adjusted LPN Staffing Hours per Resident per Day
0.60433
Adjusted RN Staffing Hours per Resident per Day
0.59121
Adjusted Total Nurse Staffing Hours per Resident per Day
2.83048
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
8
Cycle 1 Standard Survey Health Date
2014-06-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
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
32
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2012-02-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
29.33300
Number of Facility Reported Incidents
0
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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