The Ambassador Sidney Inc - Sidney Nursing Home
General Information
UPDATEFederal Provider Number
165474
Provider Name
THE AMBASSADOR SIDNEY INC
Provider Address
115 MAIN STREET
SIDNEY, IA 51652
SIDNEY, IA 51652
Provider Phone Number
7123742693
Provider SSA County
350
Provider County Name
Fremont
Ownership Type
For profit - Corporation
Number of Certified Beds
46
Number of Residents in Certified Beds
44
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THE AMBASSADOR SIDNEY INC
Date First Approved to Provide Medicare and Medicaid services
2002-11-11
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.26023
Reported LPN Staffing Hours per Resident per Day
0.12955
Reported RN Staffing Hours per Resident per Day
0.98636
Reported Licensed Staffing Hours per Resident per Day
1.11591
Reported Total Nurse Staffing Hours per Resident per Day
3.37614
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02955
Expected CNA Staffing Hours per Resident per Day
2.51172
Expected LPN Staffing Hours per Resident per Day
0.60722
Expected RN Staffing Hours per Resident per Day
0.88592
Expected Total Nurse Staffing Hours per Resident per Day
4.00486
Adjusted CNA Staffing Hours per Resident per Day
2.20802
Adjusted LPN Staffing Hours per Resident per Day
0.17708
Adjusted RN Staffing Hours per Resident per Day
0.83191
Adjusted Total Nurse Staffing Hours per Resident per Day
3.39809
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-12-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-09-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-06-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
32.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
7
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
Nursiong Homes Nearby
Tabor Manor Care Center
209 Main Street |
TABOR IA 51653 | 11.2 miles away
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