Iowa Nursing Homes >> Waukee Nursing Homes >> Independence Village Of Waukee

Independence Village Of Waukee - Waukee Nursing Home

General Information

UPDATE
Federal Provider Number
165583
Provider Name
Independence Village of Waukee
Provider Address
1645 SE HOLIDAY CREST CIRCLE
WAUKEE, IA 50263
Provider Phone Number
5159873625
Provider SSA County
240
Provider County Name
Dallas
Ownership Type
For profit - Partnership
Number of Certified Beds
48
Number of Residents in Certified Beds
45
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WATERMARK WAUKEE, LLC
Date First Approved to Provide Medicare and Medicaid services
2007-12-20
Continuing Care Retirement Community
Y
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
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
2.55889
Reported LPN Staffing Hours per Resident per Day
0.57667
Reported RN Staffing Hours per Resident per Day
1.14000
Reported Licensed Staffing Hours per Resident per Day
1.71667
Reported Total Nurse Staffing Hours per Resident per Day
4.27556
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12667
Expected CNA Staffing Hours per Resident per Day
2.45492
Expected LPN Staffing Hours per Resident per Day
0.61909
Expected RN Staffing Hours per Resident per Day
1.06517
Expected Total Nurse Staffing Hours per Resident per Day
4.13919
Adjusted CNA Staffing Hours per Resident per Day
2.55761
Adjusted LPN Staffing Hours per Resident per Day
0.77313
Adjusted RN Staffing Hours per Resident per Day
0.79969
Adjusted Total Nurse Staffing Hours per Resident per Day
4.16370
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-03-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
24
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
16
Cycle 2 Health Deficiency Score
156
Cycle 2 Standard Health Survey Date
2013-01-10
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
78
Cycle 2 Total Health Score
78
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-01-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
114.00000
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
22
Number of Fines
2
Total Amount of Fines in Dollars
16413
Number of Payment Denials
2
Total Number of Penalties
4
Location
Processing Date
2015-06-01

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