| General |
| City |
| Des Moines |
Waterloo |
| State attribute explanation |
| Ia |
Ia |
| Street |
| 900 Polk Boulevard |
600 Park Lane |
| Zip Code |
| 50,312 |
50,702 |
| Phone |
| 5,152,555,433 |
3,192,918,100 |
|
Overall Star Rating |
| 4 |
5 |
|
Health Inspections Star Rating |
| 4 |
3 |
|
Nurse Staffing Star Rating |
| 4 |
4 |
|
Quality Measures Star Rating |
| 3 |
5 |
|
RN Only Star Rating |
| 4 |
3 |
| Number of Certified Beds |
| 72 |
67 |
| Total Number of Residents |
| 52 |
67 |
|
Percent of Occupied Beds |
| 72 % |
100 % |
| Health Survey Date |
| 7/14/2011 |
2/10/2012 |
| Fire Survey Date |
| 7/18/2011 |
2/13/2012 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| Non Profit - Corporation |
Non Profit - Corporation |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| No |
No |
| Resident and Family Councils |
| Resident |
Resident |
| Continuing Care Retirement Community? |
| No |
Yes |
| Quality Indicator Survey? |
| No |
No |
| Special Focus Facility? |
| No |
No |
| Civil Money Penalty Count |
| 75.2 |
75.2 |
| Total Enforcement Actions Count |
| 75.2 |
75.2 |
| # of deficiencies |
| 2 |
8 |
|
| Staff Information |
| Number of Residents |
| 52 |
67 |
| Number of RN Hours Per Resident Per Day |
| 0.73 |
0.62 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 1.03 |
1.11 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.76 |
1.73 |
| Number of CNA Hours Per Resident Per Day |
| 0.13 |
0.09 |
| Number Therapy Hours Per Resident Per Day |
| 0.13 |
0.09 |
| Environmental Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 3deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 02/21/2011date Of Correction: 02/22/2011 |
Scope: Fewlevel Of Harm: 2deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 11/03/2011date Of Correction: 11/18/2011 |
| Deficiency #2 |
| Scope: Somelevel Of Harm: 2deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 05/28/2009date Of Correction: 08/21/2009 |
Scope: Fewlevel Of Harm: 2deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 11/20/2009date Of Correction: 12/23/2009 |
| Quality Care Deficiencies |
| Deficiency #1 |
|
Scope: Somelevel Of Harm: 1deficiency: Make Sure Services Provided By The Nursing Facility Meet Professional Standards Of Quality.survey Date: 05/24/2012date Of Correction: Not Available |
| Deficiency #2 |
|
Scope: Fewlevel Of Harm: 2deficiency: Make Sure Services Provided By The Nursing Facility Meet Professional Standards Of Quality.survey Date: 11/03/2011date Of Correction: 11/18/2011 |
| Deficiency #3 |
|
Scope: Somelevel Of Harm: 1deficiency: Develop Policies And Procedures For Influenza And Pneumococcal Immunizations.survey Date: 11/20/2009date Of Correction: 12/23/2009 |
| Deficiency #4 |
|
Scope: Fewlevel Of Harm: 2deficiency: Assist Those Residents Who Need Total Help With Eating/drinking, Grooming And Personal And Oral Hygiene.survey Date: 11/20/2009date Of Correction: 12/23/2009 |
| Deficiency #5 |
|
Scope: Fewlevel Of Harm: 2deficiency: Provide Necessary Care And Services To Maintain The Highest Well Being Of Each Resident .survey Date: 11/20/2009date Of Correction: 12/23/2009 |
| Deficiency #6 |
|
Scope: Fewlevel Of Harm: 2deficiency: Make Sure Services Provided By The Nursing Facility Meet Professional Standards Of Quality.survey Date: 11/20/2009date Of Correction: 12/23/2009 |
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 21.7 % |
23 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 1.2 % |
75.2 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 14.7:1 |
11.2-20 |
| Percent of long-stay high-risk residents with pressure ulcers |
| 75.2 % |
75.2 % |
| Percent of long-stay residents who lose too much weight |
| 4.3 % |
10 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 2.8 % |
1.9 % |
| Percent of long-stay residents with a urinary tract infection |
| 19.6 % |
1.7 % |
| Percent of long-stay residents who have depressive symptoms |
| 2.20 % |
26.7 % |
| Percent of long-stay residents who were physically restrained |
| 75.2 % |
75.2 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 18.8 % |
6.7 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 100 % |
100 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 98.6 % |
97.1 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 3.4 % |
75.2 |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 75.2 % |
1.7 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 22 % |
25.1 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 2.6 / 3 |
75.2 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 19.3 % |
11.7 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 1.8 % |
0.6 % |
| Percent of long-stay residents who lose too much weight |
| 6.1 % |
8.9 / 9.9 |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
|
46.8 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 3.1 % |
5.3 % |
| Percent of long-stay residents with a urinary tract infection |
| 17.6 % |
1.1 % |
| Percent of long-stay residents who have depressive symptoms |
| 2.3 % |
28.6 % |
| Percent of long-stay residents who were physically restrained |
| 75.2 % |
75.2 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 75.2 % |
3.3 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 25 % |
12.3:1 |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 100 % |
100 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 99.2 % |
12.6:1 |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 2.1 % |
75.2 % |