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The Madison - Fort Madison Nursing Home

General Information

UPDATE
Federal Provider Number
165227
Provider Name
THE MADISON
Provider Address
1702 41ST STREET
FORT MADISON, IA 52627
Provider Phone Number
3193728021
Provider SSA County
550
Provider County Name
Lee
Ownership Type
For profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
67
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FORT MADISON HEALTH CENTER, INC.
Date First Approved to Provide Medicare and Medicaid services
1993-08-20
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.63433
Reported LPN Staffing Hours per Resident per Day
0.84254
Reported RN Staffing Hours per Resident per Day
0.47761
Reported Licensed Staffing Hours per Resident per Day
1.32015
Reported Total Nurse Staffing Hours per Resident per Day
3.95448
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04776
Expected CNA Staffing Hours per Resident per Day
2.50197
Expected LPN Staffing Hours per Resident per Day
0.67408
Expected RN Staffing Hours per Resident per Day
0.99658
Expected Total Nurse Staffing Hours per Resident per Day
4.17263
Adjusted CNA Staffing Hours per Resident per Day
2.58350
Adjusted LPN Staffing Hours per Resident per Day
1.03743
Adjusted RN Staffing Hours per Resident per Day
0.35810
Adjusted Total Nurse Staffing Hours per Resident per Day
3.82016
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
13
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-04-10
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
34
Cycle 1 Total Health Score
102
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-03-21
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
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-03-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
64.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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