Crestview Home - Bethany Nursing Home
General Information
UPDATEFederal Provider Number
265807
Provider Name
CRESTVIEW HOME
Provider Address
1313 SOUTH 25TH ST, PO BOX 430
BETHANY, MO 64424
BETHANY, MO 64424
Provider Phone Number
6604253128
Provider SSA County
400
Provider County Name
Harrison
Ownership Type
For profit - Corporation
Number of Certified Beds
122
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
N & R OF CRESTVIEW LLC
Date First Approved to Provide Medicare and Medicaid services
2006-12-13
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.26867
Reported LPN Staffing Hours per Resident per Day
0.57133
Reported RN Staffing Hours per Resident per Day
0.35400
Reported Licensed Staffing Hours per Resident per Day
0.92533
Reported Total Nurse Staffing Hours per Resident per Day
3.19400
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00867
Expected CNA Staffing Hours per Resident per Day
2.11665
Expected LPN Staffing Hours per Resident per Day
0.56970
Expected RN Staffing Hours per Resident per Day
0.75571
Expected Total Nurse Staffing Hours per Resident per Day
3.44206
Adjusted CNA Staffing Hours per Resident per Day
2.62992
Adjusted LPN Staffing Hours per Resident per Day
0.83237
Adjusted RN Staffing Hours per Resident per Day
0.35001
Adjusted Total Nurse Staffing Hours per Resident per Day
3.74040
Cycle 1 Total Number of Health Deficiencies
22
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
13
Cycle 1 Health Deficiency Score
128
Cycle 1 Standard Survey Health Date
2014-07-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
128
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-09-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-07-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
103.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
14
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Bethany Care Center
1305 South 7th Street Po Box 273 |
BETHANY MO 64424 | 1 mile away
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