Southridge Specialty Care
309 West Merle Hibbs Boulevard, Marshalltown, IA 50158


Southridge Specialty Care is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 165209. The address is 309 West Merle Hibbs Boulevard, Marshalltown, IA 50158. The zip code is 50158. The phone number is 6417524553.


Southridge Specialty Care · 309 West Merle Hibbs Boulevard, Marshalltown, IA 50158

Federal Provider Number 165209
Provider Name SOUTHRIDGE SPECIALTY CARE
Address 309 WEST MERLE HIBBS BOULEVARD
MARSHALLTOWN, IA 50158
Phone Number 6417524553
SSA County Code 630
County Name Marshall
Ownership Type Non profit - Corporation
Certified Beds 82
Certified Beds Residents 67
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name CARE INITIATIVES
Date First Approved to Provide Medicare Medicaid Services 03/01/1994
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 2
Health Inspection Rating 2
Quality Measure Rating 4
Staffing Rating 3
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 1.90746
Reported LPN Staffing Hours per Resident per Day 0.58881
Reported RN Staffing Hours per Resident per Day 0.92388
Reported Licensed Staffing Hours per Resident per Day 1.51269
Reported Total Nurse Staffing Hours per Resident per Day 3.42015
Reported Physical Therapist Staffing Hours per Resident Per Day 0.12687
Expected CNA Staffing Hours per Resident per Day 2.30805
Expected LPN Staffing Hours per Resident per Day 0.59458
Expected RN Staffing Hours per Resident per Day 0.94643
Expected Total Nurse Staffing Hours per Resident per Day 3.84905
Adjusted CNA Staffing Hours per Resident per Day 2.02783
Adjusted LPN Staffing Hours per Resident per Day 0.82195
Adjusted RN Staffing Hours per Resident per Day 0.7294
Adjusted Total Nurse Staffing Hours per Resident per Day 3.58174
Cycle 1 Total Number of Health Deficiencies 3
Cycle 1 Number of Standard Health Deficiencies 3
Cycle 1 Number of Complaint Health Deficiencies 1
Cycle 1 Health Deficiency Score 32
Cycle 1 Standard Survey Health Date 05/18/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 32
Cycle 2 Total Number of Health Deficiencies 9
Cycle 2 Number of Standard Health Deficiencies 5
Cycle 2 Number of Complaint Health Deficiencies 4
Cycle 2 Health Deficiency Score 60
Cycle 2 Standard Health Survey Date 05/05/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 60
Cycle 3 Total Number of Health Deficiencies 2
Cycle 3 Number of Standard Health Deficiencies 1
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 4
Cycle 3 Standard Health Survey Date 07/16/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 4
Total Weighted Health Survey Score 36.667
Number of Substantiated Complaints 4
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Southridge Specialty Care

Owner Name Role Association Date
BYRNES, MICHAEL (Individual) DIRECTOR since 12/13/2013
CARE INITIATIVES (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 03/01/2014
CONLON, ROBERT (Individual) DIRECTOR since 12/09/2005
DIXON, DAVID (Individual) OFFICER since 06/01/2016
HARMOND, RON (Individual) DIRECTOR since 12/11/2003
HAVEKOST, WILLIAM (Individual) OFFICER since 11/01/2008
KAPLAN, KENT (Individual) DIRECTOR since 12/13/2013
KING, MILES (Individual) DIRECTOR since 07/25/2007
KING, MILES (Individual) OFFICER since 08/13/2008
KUHN, JERAMY (Individual) OFFICER since 06/25/2008
NORTHUP, RON (Individual) DIRECTOR since 12/07/2007
SCHLEPP, CHARLEEN (Individual) OFFICER since 04/26/2006
SMITH, JOHN (Individual) DIRECTOR since 12/10/2004
STEFFEN, MURIEL (Individual) MANAGING EMPLOYEE since 03/29/2004
WALKER, HULON (Individual) DIRECTOR since 12/11/2015
WELLS FARGO BANK NATIONAL ASSOCIATION (Organization) 5% OR GREATER MORTGAGE INTEREST since 05/01/1996

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