Bethesda Meadow - Ellisville Nursing Home
General Information
UPDATEFederal Provider Number
265766
Provider Name
BETHESDA MEADOW
Provider Address
322 OLD STATE ROAD
ELLISVILLE, MO 63021
ELLISVILLE, MO 63021
Provider Phone Number
6362273431
Provider SSA County
940
Provider County Name
St. Louis
Ownership Type
Non profit - Corporation
Number of Certified Beds
210
Number of Residents in Certified Beds
134
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BETHESDA LONG TERM CARE INC
Date First Approved to Provide Medicare and Medicaid services
2003-08-14
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
1.96007
Reported LPN Staffing Hours per Resident per Day
0.87948
Reported RN Staffing Hours per Resident per Day
0.75634
Reported Licensed Staffing Hours per Resident per Day
1.63582
Reported Total Nurse Staffing Hours per Resident per Day
3.59589
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05933
Expected CNA Staffing Hours per Resident per Day
2.42764
Expected LPN Staffing Hours per Resident per Day
0.58234
Expected RN Staffing Hours per Resident per Day
0.92255
Expected Total Nurse Staffing Hours per Resident per Day
3.93253
Adjusted CNA Staffing Hours per Resident per Day
1.98111
Adjusted LPN Staffing Hours per Resident per Day
1.25351
Adjusted RN Staffing Hours per Resident per Day
0.61258
Adjusted Total Nurse Staffing Hours per Resident per Day
3.68584
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-03-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2014-01-17
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
7
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
2013-03-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
43.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
11
Number of Fines
1
Total Amount of Fines in Dollars
8775
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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