| General |
| City |
| Des Moines |
Villisca |
| State attribute explanation |
| Ia |
Ia |
| Street |
| 900 Polk Boulevard |
202 North Central Avenue |
| Zip Code |
| 50,312 |
50,864 |
| Phone |
| 5,152,555,433 |
7,128,269,592 |
|
Overall Star Rating |
| 4 |
4 |
|
Health Inspections Star Rating |
| 4 |
4 |
|
Nurse Staffing Star Rating |
| 4 |
3 |
|
Quality Measures Star Rating |
| 3 |
4 |
|
RN Only Star Rating |
| 4 |
4 |
| Number of Certified Beds |
| 72 |
50 |
| Total Number of Residents |
| 52 |
39 |
|
Percent of Occupied Beds |
| 72 % |
78 % |
| Health Survey Date |
| 7/14/2011 |
6/14/2012 |
| Fire Survey Date |
| 7/18/2011 |
6/18/2012 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| Non Profit - Corporation |
Non Profit - Church Related |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| No |
Yes |
| Resident and Family Councils |
| Resident |
Resident |
| Continuing Care Retirement Community? |
| No |
No |
| 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 |
3 |
|
| Staff Information |
| Number of Residents |
| 52 |
39 |
| Number of RN Hours Per Resident Per Day |
| 0.73 |
0.68 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 1.03 |
0.72 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.76 |
1.4 |
| Number of CNA Hours Per Resident Per Day |
| 0.13 |
0.06 |
| Number Therapy Hours Per Resident Per Day |
| 0.13 |
0.06 |
| 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: Somelevel Of Harm: 1deficiency: Make Sure That The Nursing Home Area Is Safe, Easy To Use, Clean And Comfortable For Residents, Staff And The Public.survey Date: 11/28/2011date Of Correction: 12/16/2011 |
| 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 |
|
| Resident Rights Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 2deficiency: Provide Care For Residents In A Way That Keeps Or Builds Each Resident's Dignity And Respect Of Individuality.survey Date: 11/28/2011date Of Correction: 12/16/2011 |
| Nutrition and Dietary Deficiencies |
| Deficiency #1 |
|
Scope: Manylevel Of Harm: 1deficiency: Store, Cook, And Serve Food In A Safe And Clean Way.survey Date: 11/28/2011date Of Correction: 12/16/2011 |
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 21.7 % |
27 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 1.2 % |
|
| Percent of long-stay residents who self-report moderate to severe pain |
| 14.7:1 |
|
| Percent of long-stay high-risk residents with pressure ulcers |
| 75.2 % |
|
| Percent of long-stay residents who lose too much weight |
| 4.3 % |
13.5 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 2.8 % |
6.7 % |
| Percent of long-stay residents with a urinary tract infection |
| 19.6 % |
8.1 / 8.8 |
| Percent of long-stay residents who have depressive symptoms |
| 2.20 % |
7.9:1 |
| 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 % |
|
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 100 % |
|
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 98.6 % |
|
| 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 % |
5.3 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 22 % |
25.9 % |
| 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 % |
6.8 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 1.8 % |
2.20 % |
| Percent of long-stay residents who lose too much weight |
| 6.1 % |
14.5 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
|
52.1 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 3.1 % |
8.5 % |
| Percent of long-stay residents with a urinary tract infection |
| 17.6 % |
7.7 % |
| Percent of long-stay residents who have depressive symptoms |
| 2.3 % |
7.6 % |
| 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 % |
11.1 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 25 % |
|
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 100 % |
97.1 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 99.2 % |
95 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 2.1 % |
3.7 % |