Scottish Rite Park Inc - Des Moines Nursing Home

General Information

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Federal Provider Number
165593
Provider Name
SCOTTISH RITE PARK INC
Provider Address
2909 WOODLAND AVENUE
DES MOINES, IA 50312
Provider Phone Number
(515) 274-4614
Provider SSA County
760
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
51
Number of Residents in Certified Beds
33
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SCOTTISH RITE PARK INC
Date First Approved to Provide Medicare and Medicaid services
2009-05-22
Continuing Care Retirement Community
Y
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
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
4.14697
Reported LPN Staffing Hours per Resident per Day
1.05606
Reported RN Staffing Hours per Resident per Day
0.77121
Reported Licensed Staffing Hours per Resident per Day
1.82727
Reported Total Nurse Staffing Hours per Resident per Day
5.97424
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07727
Expected CNA Staffing Hours per Resident per Day
2.54808
Expected LPN Staffing Hours per Resident per Day
0.57559
Expected RN Staffing Hours per Resident per Day
1.02585
Expected Total Nurse Staffing Hours per Resident per Day
4.14952
Adjusted CNA Staffing Hours per Resident per Day
3.99337
Adjusted LPN Staffing Hours per Resident per Day
1.52283
Adjusted RN Staffing Hours per Resident per Day
0.56173
Adjusted Total Nurse Staffing Hours per Resident per Day
5.80346
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-11-26
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
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-10-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-08-08
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
29.33300
Number of Facility Reported Incidents
3
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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