Urbandale Health Care Center - Urbandale Nursing Home
General Information
UPDATEFederal Provider Number
165580
Provider Name
URBANDALE HEALTH CARE CENTER
Provider Address
4614 NW 84TH STREET
URBANDALE, IA 50322
URBANDALE, IA 50322
Provider Phone Number
(515) 270-6838
Provider SSA County
760
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
130
Number of Residents in Certified Beds
101
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
URBANDALE HEALTH CARE CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
2007-07-09
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.04010
Reported LPN Staffing Hours per Resident per Day
0.88020
Reported RN Staffing Hours per Resident per Day
0.62525
Reported Licensed Staffing Hours per Resident per Day
1.50545
Reported Total Nurse Staffing Hours per Resident per Day
3.54555
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06386
Expected CNA Staffing Hours per Resident per Day
2.43624
Expected LPN Staffing Hours per Resident per Day
0.64481
Expected RN Staffing Hours per Resident per Day
1.08811
Expected Total Nurse Staffing Hours per Resident per Day
4.16916
Adjusted CNA Staffing Hours per Resident per Day
2.05472
Adjusted LPN Staffing Hours per Resident per Day
1.13300
Adjusted RN Staffing Hours per Resident per Day
0.42936
Adjusted Total Nurse Staffing Hours per Resident per Day
3.42797
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-07-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
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
20
Cycle 2 Standard Health Survey Date
2013-05-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-04-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
58.66700
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
10
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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