Schuyler County Nursing Home - Queen City Nursing Home
General Information
UPDATEFederal Provider Number
265816
Provider Name
SCHUYLER COUNTY NURSING HOME
Provider Address
HIGHWAY 63 NORTH, ROUTE 1, BOX 212
QUEEN CITY, MO 63561
QUEEN CITY, MO 63561
Provider Phone Number
6607662291
Provider SSA County
980
Provider County Name
Schuyler
Ownership Type
Government - County
Number of Certified Beds
60
Number of Residents in Certified Beds
45
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SCHUYLER COUNTY NURSING HOME DISTRICT
Date First Approved to Provide Medicare and Medicaid services
2007-07-16
Continuing Care Retirement Community
N
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.65222
Reported LPN Staffing Hours per Resident per Day
0.60000
Reported RN Staffing Hours per Resident per Day
0.62667
Reported Licensed Staffing Hours per Resident per Day
1.22667
Reported Total Nurse Staffing Hours per Resident per Day
3.87889
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02333
Expected CNA Staffing Hours per Resident per Day
2.16888
Expected LPN Staffing Hours per Resident per Day
0.55862
Expected RN Staffing Hours per Resident per Day
0.84526
Expected Total Nurse Staffing Hours per Resident per Day
3.57276
Adjusted CNA Staffing Hours per Resident per Day
3.00051
Adjusted LPN Staffing Hours per Resident per Day
0.89148
Adjusted RN Staffing Hours per Resident per Day
0.55397
Adjusted Total Nurse Staffing Hours per Resident per Day
4.37628
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2015-04-15
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
107
Cycle 2 Standard Health Survey Date
2014-06-18
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
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2013-05-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
85.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
6000
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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