State Center Nursing & Rehab C - State Center Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165390
Provider Name
STATE CENTER NURSING & REHAB C
Provider Address
702 THIRD STREET NW
STATE CENTER, IA 50247
STATE CENTER, IA 50247
Provider Phone Number
(641) 483-2812
Provider SSA County
630
Provider County Name
Marshall
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
48
Number of Residents in Certified Beds
35
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
1998-04-01
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
5
QM Rating Footnote
Staffing Rating
4
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
2.37857
Reported LPN Staffing Hours per Resident per Day
0.18714
Reported RN Staffing Hours per Resident per Day
0.94286
Reported Licensed Staffing Hours per Resident per Day
1.13000
Reported Total Nurse Staffing Hours per Resident per Day
3.50857
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06571
Expected CNA Staffing Hours per Resident per Day
2.14508
Expected LPN Staffing Hours per Resident per Day
0.56082
Expected RN Staffing Hours per Resident per Day
0.82330
Expected Total Nurse Staffing Hours per Resident per Day
3.52920
Adjusted CNA Staffing Hours per Resident per Day
2.72079
Adjusted LPN Staffing Hours per Resident per Day
0.27696
Adjusted RN Staffing Hours per Resident per Day
0.85571
Adjusted Total Nurse Staffing Hours per Resident per Day
4.00733
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-07-17
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
1
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-05-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
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
20
Cycle 3 Standard Health Survey Date
2012-05-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
4.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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