Salem Lutheran Home - Elk Horn Nursing Home
General Information
UPDATEFederal Provider Number
165155
Provider Name
SALEM LUTHERAN HOME
Provider Address
2027 COLLEGE AVENUE
ELK HORN, IA 51531
ELK HORN, IA 51531
Provider Phone Number
7127644201
Provider SSA County
820
Provider County Name
Shelby
Ownership Type
Non profit - Corporation
Number of Certified Beds
74
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AMERICAN LUTHERAN CHURCH, SALEM LUTHERAN HOMES
Date First Approved to Provide Medicare and Medicaid services
1990-05-01
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
3
Health Inspection Rating Footnote
QM Rating
5
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
1.89615
Reported LPN Staffing Hours per Resident per Day
1.03846
Reported RN Staffing Hours per Resident per Day
0.50154
Reported Licensed Staffing Hours per Resident per Day
1.54000
Reported Total Nurse Staffing Hours per Resident per Day
3.43615
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02538
Expected CNA Staffing Hours per Resident per Day
2.20488
Expected LPN Staffing Hours per Resident per Day
0.53558
Expected RN Staffing Hours per Resident per Day
0.80409
Expected Total Nurse Staffing Hours per Resident per Day
3.54456
Adjusted CNA Staffing Hours per Resident per Day
2.11013
Adjusted LPN Staffing Hours per Resident per Day
1.60933
Adjusted RN Staffing Hours per Resident per Day
0.46605
Adjusted Total Nurse Staffing Hours per Resident per Day
3.90762
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-05-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-03-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-03-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
32.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
1008
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Elm Crest Retirement Community
2104 12th Street |
HARLAN IA 51537 | 14.2 miles away
Little Flower Haven
736 Highway 37 |
EARLING IA 51530 | 22.7 miles away
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