Sioux Center Comm Hsp & Health - Sioux Center Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165157
Provider Name
SIOUX CENTER COMM HSP & HEALTH
Provider Address
1400 7TH AVENUE SE
SIOUX CENTER, IA 51250
SIOUX CENTER, IA 51250
Provider Phone Number
(712) 722-8305
Provider SSA County
830
Provider County Name
Sioux
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
69
Number of Residents in Certified Beds
63
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
SIOUX CENTER HEALTH
Date First Approved to Provide Medicare and Medicaid services
1990-10-04
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.28333
Reported LPN Staffing Hours per Resident per Day
0.22619
Reported RN Staffing Hours per Resident per Day
0.94286
Reported Licensed Staffing Hours per Resident per Day
1.16905
Reported Total Nurse Staffing Hours per Resident per Day
4.45238
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01111
Expected CNA Staffing Hours per Resident per Day
2.23375
Expected LPN Staffing Hours per Resident per Day
0.53243
Expected RN Staffing Hours per Resident per Day
0.70207
Expected Total Nurse Staffing Hours per Resident per Day
3.46825
Adjusted CNA Staffing Hours per Resident per Day
3.60663
Adjusted LPN Staffing Hours per Resident per Day
0.35261
Adjusted RN Staffing Hours per Resident per Day
1.00347
Adjusted Total Nurse Staffing Hours per Resident per Day
5.17468
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-06-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
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
28
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
2012-03-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
14.66700
Number of Facility Reported Incidents
1
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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