Beth Haven Nursing Home - Hannibal Nursing Home
General Information
UPDATEFederal Provider Number
265108
Provider Name
BETH HAVEN NURSING HOME
Provider Address
2500 PLEASANT STREET
HANNIBAL, MO 63401
HANNIBAL, MO 63401
Provider Phone Number
(573) 221-6000
Provider SSA County
630
Provider County Name
Marion
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
105
Number of Residents in Certified Beds
94
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MENNONITE HOME ASSOCIATION INC.
Date First Approved to Provide Medicare and Medicaid services
1972-04-07
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
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
3.31436
Reported LPN Staffing Hours per Resident per Day
1.25213
Reported RN Staffing Hours per Resident per Day
0.32819
Reported Licensed Staffing Hours per Resident per Day
1.58032
Reported Total Nurse Staffing Hours per Resident per Day
4.89468
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00585
Expected CNA Staffing Hours per Resident per Day
2.26546
Expected LPN Staffing Hours per Resident per Day
0.54492
Expected RN Staffing Hours per Resident per Day
0.78580
Expected Total Nurse Staffing Hours per Resident per Day
3.59618
Adjusted CNA Staffing Hours per Resident per Day
3.58976
Adjusted LPN Staffing Hours per Resident per Day
1.90720
Adjusted RN Staffing Hours per Resident per Day
0.31207
Adjusted Total Nurse Staffing Hours per Resident per Day
5.48637
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-10-16
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
38
Cycle 1 Total Health Score
114
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
87
Cycle 2 Standard Health Survey Date
2013-08-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
87
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-10-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
87.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
4713
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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