Bethesda Home - Goessel Nursing Home
General Information
UPDATEFederal Provider Number
175403
Provider Name
BETHESDA HOME
Provider Address
408 E MAIN PO BOX 37
GOESSEL, KS 67053
GOESSEL, KS 67053
Provider Phone Number
6203672291
Provider SSA County
570
Provider County Name
Marion
Ownership Type
Non profit - Corporation
Number of Certified Beds
67
Number of Residents in Certified Beds
52
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MENNONITE BETHESDA SOCIETY, INC.
Date First Approved to Provide Medicare and Medicaid services
1997-01-01
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.70577
Reported LPN Staffing Hours per Resident per Day
1.05769
Reported RN Staffing Hours per Resident per Day
1.00577
Reported Licensed Staffing Hours per Resident per Day
2.06346
Reported Total Nurse Staffing Hours per Resident per Day
4.76923
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00577
Expected CNA Staffing Hours per Resident per Day
2.33091
Expected LPN Staffing Hours per Resident per Day
0.59706
Expected RN Staffing Hours per Resident per Day
0.80469
Expected Total Nurse Staffing Hours per Resident per Day
3.73266
Adjusted CNA Staffing Hours per Resident per Day
2.84831
Adjusted LPN Staffing Hours per Resident per Day
1.47034
Adjusted RN Staffing Hours per Resident per Day
0.93392
Adjusted Total Nurse Staffing Hours per Resident per Day
5.15029
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-03-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-12-23
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
103
Cycle 3 Standard Health Survey Date
2012-10-24
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
103
Total Weighted Health Survey Score
38.50000
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
3250
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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