Shell Rock Senior Living - Shell Rock Nursing Home

General Information

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Federal Provider Number
165309
Provider Name
SHELL ROCK SENIOR LIVING
Provider Address
920 NORTH CHERRY STREET
SHELL ROCK, IA 50670
Provider Phone Number
(319) 885-4341
Provider SSA County
110
Provider County Name
Butler
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
44
Number of Residents in Certified Beds
35
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SHELL ROCK HEALTHCARE CENTER INC
Date First Approved to Provide Medicare and Medicaid services
1997-01-01
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
2.72429
Reported LPN Staffing Hours per Resident per Day
0.72571
Reported RN Staffing Hours per Resident per Day
0.76286
Reported Licensed Staffing Hours per Resident per Day
1.48857
Reported Total Nurse Staffing Hours per Resident per Day
4.21286
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.36282
Expected LPN Staffing Hours per Resident per Day
0.57543
Expected RN Staffing Hours per Resident per Day
0.87977
Expected Total Nurse Staffing Hours per Resident per Day
3.81802
Adjusted CNA Staffing Hours per Resident per Day
2.82907
Adjusted LPN Staffing Hours per Resident per Day
1.04677
Adjusted RN Staffing Hours per Resident per Day
0.64791
Adjusted Total Nurse Staffing Hours per Resident per Day
4.44776
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-10-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
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
12
Cycle 2 Standard Health Survey Date
2013-07-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-05-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
20.00000
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
2
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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