Bethel Home - Montezuma Nursing Home
General Information
UPDATEFederal Provider Number
175528
Provider Name
BETHEL HOME
Provider Address
300 S AZTEC ST
MONTEZUMA, KS 67867
MONTEZUMA, KS 67867
Provider Phone Number
6208462241
Provider SSA County
340
Provider County Name
Gray
Ownership Type
Non profit - Church related
Number of Certified Beds
55
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BETHEL HOME, INC.
Date First Approved to Provide Medicare and Medicaid services
2012-08-28
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
3
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
2.55091
Reported LPN Staffing Hours per Resident per Day
0.54909
Reported RN Staffing Hours per Resident per Day
0.52000
Reported Licensed Staffing Hours per Resident per Day
1.06909
Reported Total Nurse Staffing Hours per Resident per Day
3.62000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00909
Expected CNA Staffing Hours per Resident per Day
2.19434
Expected LPN Staffing Hours per Resident per Day
0.53502
Expected RN Staffing Hours per Resident per Day
0.69490
Expected Total Nurse Staffing Hours per Resident per Day
3.42427
Adjusted CNA Staffing Hours per Resident per Day
2.85241
Adjusted LPN Staffing Hours per Resident per Day
0.85183
Adjusted RN Staffing Hours per Resident per Day
0.55913
Adjusted Total Nurse Staffing Hours per Resident per Day
4.26131
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-11-06
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-07-25
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-05-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
10.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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
The Shepherd's Center
706 N Main Po Box 249 |
CIMARRON KS 67835 | 16.1 miles away
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