| General |
| City |
| Davenport |
Perry |
| State attribute explanation |
| Ia |
Ia |
| Street |
| 4130 Northwest Boulevard |
3000 East Willis Avenue |
| Zip Code |
| 52,806 |
50,220 |
| Phone |
| 5,633,913,430 |
5,154,655,316 |
|
Overall Star Rating |
| 3 |
3 |
|
Health Inspections Star Rating |
| 2 |
3 |
|
Nurse Staffing Star Rating |
| 4 |
3 |
|
Quality Measures Star Rating |
| 4 |
4 |
|
RN Only Star Rating |
| 4 |
5 |
|
Number of Certified Beds |
| 137 |
57 |
|
Total Number of Residents |
| 97 |
50 |
|
Percent of Occupied Beds |
| 71 % |
88 % |
| Health Survey Date |
| 4/20/2012 |
12/21/2011 |
| Fire Survey Date |
| 4/24/2012 |
12/28/2011 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| Non Profit - Corporation |
Non Profit - Other |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| No |
No |
| Resident and Family Councils |
| Both |
None |
| Continuing Care Retirement Community? |
| Yes |
Yes |
| Quality Indicator Survey? |
| No |
No |
| Special Focus Facility? |
| No |
No |
| Civil Money Penalty Count |
| 1 |
75.2 |
| Total Enforcement Actions Count |
| 1 |
75.2 |
| # of deficiencies |
| 6 |
1 |
|
| Staff Information |
| Number of Residents |
| 97 |
50 |
| Number of RN Hours Per Resident Per Day |
| 0.7 |
0.88 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 0.98 |
0.33 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.69 |
1.21 |
| Number of CNA Hours Per Resident Per Day |
| 0.08 |
75.2 |
| Number Therapy Hours Per Resident Per Day |
| 0.08 |
|
| Environmental Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 4deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 12/22/2010date Of Correction: 01/24/2011 |
|
| Mistreatment Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Keep Each Resident Free From Physical Restraints, Unless Needed For Medical Treatment.survey Date: 03/19/2010date Of Correction: 04/19/2010 |
|
| Resident Rights Deficiencies |
| Deficiency #1 |
| Scope: Somelevel Of Harm: 2deficiency: Give Each Resident A Notice Of Rights, Rules, Services And Charges. Tell Each Resident Who Can Get Medicaid Benefits About 1) Which Items And Services Medicaid Covers And Which The Resident Must Pay For.survey Date: 04/17/2009date Of Correction: 05/17/2009 |
Scope: Manylevel Of Harm: 1deficiency: Immediately Tell The Resident, The Resident's Doctor And A Family Member Of The Resident Of Situations (injury/decline/room, Etc.) That Affect The Resident.survey Date: 06/14/2012date Of Correction: 06/25/2012 |
| Quality Care Deficiencies |
| Deficiency #1 |
| Scope: Somelevel Of Harm: 2deficiency: Develop Policies And Procedures For Influenza And Pneumococcal Immunizations.survey Date: 03/19/2010date Of Correction: 04/19/2010 |
|
| Deficiency #2 |
| Scope: Fewlevel Of Harm: 2deficiency: Provide Care By Qualified Persons According To Each Resident's Written Plan Of Care.survey Date: 04/17/2009date Of Correction: 05/17/2009 |
|
| Resident Assessment Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure That Doctors Visit Residents Regularly, As Required.survey Date: 12/22/2010date Of Correction: 01/24/2011 |
|
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 17.3:1 |
16.3:1 |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 2.6 / 3 |
|
| Percent of long-stay residents who self-report moderate to severe pain |
| 7.4 % |
13.1:1 |
| Percent of long-stay high-risk residents with pressure ulcers |
| 3.7 % |
|
| Percent of long-stay residents who lose too much weight |
| 2.5 % |
4.1 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 41.7 % |
|
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 4.3 % |
2.20 % |
| Percent of long-stay residents with a urinary tract infection |
| 12.3:1 |
20.4 % |
| Percent of long-stay residents who have depressive symptoms |
| 75.2 % |
12.8:1 |
| 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 |
| 14.3 % |
|
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 78.3 % |
|
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 88.2 % |
|
| Percent of short-stay residents who newly received an antipsychotic medication |
| 75.2 % |
75.2 |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 4.8 % |
2 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 17.7 % |
13.3 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 2 % |
75.2 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 7 % |
16.1 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 1.9 % |
5.2 % |
| Percent of long-stay residents who lose too much weight |
| 2.7 % |
6.7 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 35.8 % |
62.3 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 3.9 % |
0.7 % |
| Percent of long-stay residents with a urinary tract infection |
| 12.2 % |
15.3 % |
| Percent of long-stay residents who have depressive symptoms |
| 75.2 % |
16.4 % |
| Percent of long-stay residents who were physically restrained |
| 0.4 % |
75.2 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 3.5 % |
27 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 10.9 % |
10.8 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 65.7 % |
81.3 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 83.5 % |
93 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 10.4 % |
|