Rolling Green Village Care Cen - Nevada Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165361
Provider Name
ROLLING GREEN VILLAGE CARE CEN
Provider Address
100 SIXTH STREET
NEVADA, IA 50201
NEVADA, IA 50201
Provider Phone Number
(515) 382-6556
Provider SSA County
840
Provider County Name
Story
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
69
Number of Residents in Certified Beds
61
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ABCM CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1997-10-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.28361
Reported LPN Staffing Hours per Resident per Day
0.71148
Reported RN Staffing Hours per Resident per Day
0.48279
Reported Licensed Staffing Hours per Resident per Day
1.19426
Reported Total Nurse Staffing Hours per Resident per Day
3.47788
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08934
Expected CNA Staffing Hours per Resident per Day
2.29704
Expected LPN Staffing Hours per Resident per Day
0.58910
Expected RN Staffing Hours per Resident per Day
0.84808
Expected Total Nurse Staffing Hours per Resident per Day
3.73422
Adjusted CNA Staffing Hours per Resident per Day
2.43936
Adjusted LPN Staffing Hours per Resident per Day
1.00242
Adjusted RN Staffing Hours per Resident per Day
0.42536
Adjusted Total Nurse Staffing Hours per Resident per Day
3.75420
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
11
Cycle 2 Health Deficiency Score
104
Cycle 2 Standard Health Survey Date
2014-02-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
104
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2013-01-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
62.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
5
Number of Fines
1
Total Amount of Fines in Dollars
4680
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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