Thomas Rest Haven - Coon Rapids Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165358
Provider Name
THOMAS REST HAVEN
Provider Address
217 MAIN STREET
COON RAPIDS, IA 50058
COON RAPIDS, IA 50058
Provider Phone Number
(712) 999-2253
Provider SSA County
130
Provider County Name
Carroll
Provider Website
Provider Description
Ownership Type
Government - City/county
Number of Certified Beds
57
Number of Residents in Certified Beds
38
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THOMAS REST HAVEN
Date First Approved to Provide Medicare and Medicaid services
1997-10-01
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
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
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
2.78684
Reported LPN Staffing Hours per Resident per Day
0.55658
Reported RN Staffing Hours per Resident per Day
0.97632
Reported Licensed Staffing Hours per Resident per Day
1.53289
Reported Total Nurse Staffing Hours per Resident per Day
4.31974
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01447
Expected CNA Staffing Hours per Resident per Day
2.23398
Expected LPN Staffing Hours per Resident per Day
0.51873
Expected RN Staffing Hours per Resident per Day
0.73581
Expected Total Nurse Staffing Hours per Resident per Day
3.48852
Adjusted CNA Staffing Hours per Resident per Day
3.06093
Adjusted LPN Staffing Hours per Resident per Day
0.89055
Adjusted RN Staffing Hours per Resident per Day
0.99144
Adjusted Total Nurse Staffing Hours per Resident per Day
4.99135
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-09-04
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
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-08-08
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
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
32
Total Weighted Health Survey Score
15.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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