Shady Oaks Care Center
1409 West Main Street, Lake City, IA 51449


Shady Oaks Care Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 165082. The address is 1409 West Main Street, Lake City, IA 51449. The zip code is 51449. The phone number is 7124643106.


Shady Oaks Care Center · 1409 West Main Street, Lake City, IA 51449

Federal Provider Number 165082
Provider Name SHADY OAKS CARE CENTER
Address 1409 WEST MAIN STREET
LAKE CITY, IA 51449
Phone Number 7124643106
SSA County Code 120
County Name Calhoun
Ownership Type For profit - Corporation
Certified Beds 80
Certified Beds Residents 62
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name MANOR OF LAKE CITY, INC
Date First Approved to Provide Medicare Medicaid Services 09/06/1968
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 3
Health Inspection Rating 2
Quality Measure Rating 4
Staffing Rating 5
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 2.54435
Reported LPN Staffing Hours per Resident per Day 0.70403
Reported RN Staffing Hours per Resident per Day 0.77661
Reported Licensed Staffing Hours per Resident per Day 1.48065
Reported Total Nurse Staffing Hours per Resident per Day 4.02499
Reported Physical Therapist Staffing Hours per Resident Per Day 0.02097
Expected CNA Staffing Hours per Resident per Day 2.09872
Expected LPN Staffing Hours per Resident per Day 0.55483
Expected RN Staffing Hours per Resident per Day 0.79373
Expected Total Nurse Staffing Hours per Resident per Day 3.44728
Adjusted CNA Staffing Hours per Resident per Day 2.97471
Adjusted LPN Staffing Hours per Resident per Day 1.0532
Adjusted RN Staffing Hours per Resident per Day 0.73108
Adjusted Total Nurse Staffing Hours per Resident per Day 4.70642
Cycle 1 Total Number of Health Deficiencies 9
Cycle 1 Number of Standard Health Deficiencies 7
Cycle 1 Number of Complaint Health Deficiencies 2
Cycle 1 Health Deficiency Score 48
Cycle 1 Standard Survey Health Date 05/18/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 48
Cycle 2 Total Number of Health Deficiencies 8
Cycle 2 Number of Standard Health Deficiencies 5
Cycle 2 Number of Complaint Health Deficiencies 8
Cycle 2 Health Deficiency Score 80
Cycle 2 Standard Health Survey Date 03/28/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 80
Cycle 3 Total Number of Health Deficiencies 6
Cycle 3 Number of Standard Health Deficiencies 5
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 16
Cycle 3 Standard Health Survey Date 04/23/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 16
Total Weighted Health Survey Score 53.333
Number of Facility Reported Incidents 5
Number of Substantiated Complaints 2
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Shady Oaks Care Center

Owner Name Role Association Date
DUNLAP, AARON (Individual) OPERATIONAL/MANAGERIAL CONTROL since 10/01/2009
MYERS, JENNIFER (Individual) OPERATIONAL/MANAGERIAL CONTROL since 04/01/2015
SCHELM, JOAN (Individual) DIRECTOR since 10/19/2009
VETTER HEALTH SERVICES, INC. (Organization) OPERATIONAL/MANAGERIAL CONTROL since 10/01/2009
VETTER HOLDING, INC. (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 10/01/2009
VETTER, ELDORA (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 10/19/2009
VETTER, JACK (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 10/19/2009

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