Windmill Manor - Coralville Nursing Home

General Information

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Federal Provider Number
165545
Provider Name
WINDMILL MANOR
Provider Address
2332 LIBERTY DRIVE
CORALVILLE, IA 52241
Provider Phone Number
(319) 545-7390
Provider SSA County
510
Provider County Name
Johnson
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2004-06-29
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
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
2.50523
Reported LPN Staffing Hours per Resident per Day
0.74360
Reported RN Staffing Hours per Resident per Day
0.60523
Reported Licensed Staffing Hours per Resident per Day
1.34884
Reported Total Nurse Staffing Hours per Resident per Day
3.85406
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15523
Expected CNA Staffing Hours per Resident per Day
2.39273
Expected LPN Staffing Hours per Resident per Day
0.67207
Expected RN Staffing Hours per Resident per Day
1.07954
Expected Total Nurse Staffing Hours per Resident per Day
4.14434
Adjusted CNA Staffing Hours per Resident per Day
2.56906
Adjusted LPN Staffing Hours per Resident per Day
0.91834
Adjusted RN Staffing Hours per Resident per Day
0.41891
Adjusted Total Nurse Staffing Hours per Resident per Day
3.74856
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-03-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
19
Cycle 2 Number of Standard Health Deficiencies
15
Cycle 2 Number of Complaint Health Deficiencies
18
Cycle 2 Health Deficiency Score
124
Cycle 2 Standard Health Survey Date
2013-02-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
124
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
104
Cycle 3 Standard Health Survey Date
2012-01-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
104
Total Weighted Health Survey Score
96.66700
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
11
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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