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Tripoli Nursing & Rehab - Tripoli Nursing Home

General Information

UPDATE
Federal Provider Number
165494
Provider Name
TRIPOLI NURSING & REHAB
Provider Address
604 THIRD STREET SW
TRIPOLI, IA 50676
Provider Phone Number
3198824269
Provider SSA County
80
Provider County Name
Bremer
Ownership Type
Non profit - Corporation
Number of Certified Beds
32
Number of Residents in Certified Beds
23
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRIPOLI NURSING AND REHAB
Date First Approved to Provide Medicare and Medicaid services
2003-10-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.43696
Reported LPN Staffing Hours per Resident per Day
1.40217
Reported RN Staffing Hours per Resident per Day
0.45000
Reported Licensed Staffing Hours per Resident per Day
1.85217
Reported Total Nurse Staffing Hours per Resident per Day
5.28913
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02174
Expected CNA Staffing Hours per Resident per Day
2.23349
Expected LPN Staffing Hours per Resident per Day
0.57350
Expected RN Staffing Hours per Resident per Day
0.76373
Expected Total Nurse Staffing Hours per Resident per Day
3.57072
Adjusted CNA Staffing Hours per Resident per Day
3.77583
Adjusted LPN Staffing Hours per Resident per Day
2.02929
Adjusted RN Staffing Hours per Resident per Day
0.44026
Adjusted Total Nurse Staffing Hours per Resident per Day
5.97077
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
16
Cycle 1 Standard Survey Health Date
2015-04-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
96
Cycle 2 Standard Health Survey Date
2014-03-13
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
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2013-02-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
43.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
6
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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