Willow Dale Wellness Village - Battle Creek Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
165342
Provider Name
WILLOW DALE WELLNESS VILLAGE
Provider Address
404 FIRST STREET
BATTLE CREEK, IA 51006
BATTLE CREEK, IA 51006
Provider Phone Number
(712) 365-4332
Provider SSA County
460
Provider County Name
Ida
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
38
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ABCM CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1997-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
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
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.88947
Reported LPN Staffing Hours per Resident per Day
0.80263
Reported RN Staffing Hours per Resident per Day
0.67895
Reported Licensed Staffing Hours per Resident per Day
1.48158
Reported Total Nurse Staffing Hours per Resident per Day
4.37105
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.15115
Expected LPN Staffing Hours per Resident per Day
0.55388
Expected RN Staffing Hours per Resident per Day
0.89771
Expected Total Nurse Staffing Hours per Resident per Day
3.60274
Adjusted CNA Staffing Hours per Resident per Day
3.29587
Adjusted LPN Staffing Hours per Resident per Day
1.20275
Adjusted RN Staffing Hours per Resident per Day
0.56512
Adjusted Total Nurse Staffing Hours per Resident per Day
4.89052
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2014-01-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-11-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
32.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
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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