Southridge Nursing & Rehab Cen - Marshalltown Nursing Home
General Information
UPDATEFederal Provider Number
165209
Provider Name
SOUTHRIDGE NURSING & REHAB CEN
Provider Address
309 WEST MERLE HIBBS BOULEVARD
MARSHALLTOWN, IA 50158
MARSHALLTOWN, IA 50158
Provider Phone Number
(641) 752-4553
Provider SSA County
630
Provider County Name
Marshall
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
82
Number of Residents in Certified Beds
70
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CARE INITIATIVES INC
Date First Approved to Provide Medicare and Medicaid services
1994-03-01
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
5
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
2.47714
Reported LPN Staffing Hours per Resident per Day
0.71143
Reported RN Staffing Hours per Resident per Day
0.69214
Reported Licensed Staffing Hours per Resident per Day
1.40357
Reported Total Nurse Staffing Hours per Resident per Day
3.88071
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09786
Expected CNA Staffing Hours per Resident per Day
2.55713
Expected LPN Staffing Hours per Resident per Day
0.62895
Expected RN Staffing Hours per Resident per Day
0.96155
Expected Total Nurse Staffing Hours per Resident per Day
4.14762
Adjusted CNA Staffing Hours per Resident per Day
2.37695
Adjusted LPN Staffing Hours per Resident per Day
0.93885
Adjusted RN Staffing Hours per Resident per Day
0.53785
Adjusted Total Nurse Staffing Hours per Resident per Day
3.77150
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-06-19
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-04-11
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-03-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
3.33300
Number of Facility Reported Incidents
0
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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