Carroll House - Carrollton Nursing Home

General Information

UPDATE
Federal Provider Number
265706
Provider Name
CARROLL HOUSE
Provider Address
307 GRAND
CARROLLTON, MO 64633
Provider Phone Number
(660) 542-1599
Provider SSA County
160
Provider County Name
Carroll
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
54
Number of Residents in Certified Beds
41
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CARROLL HOUSE, INC.
Date First Approved to Provide Medicare and Medicaid services
2000-03-29
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.91220
Reported LPN Staffing Hours per Resident per Day
0.70122
Reported RN Staffing Hours per Resident per Day
1.00122
Reported Licensed Staffing Hours per Resident per Day
1.70244
Reported Total Nurse Staffing Hours per Resident per Day
4.61464
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.17502
Expected LPN Staffing Hours per Resident per Day
0.58406
Expected RN Staffing Hours per Resident per Day
0.92078
Expected Total Nurse Staffing Hours per Resident per Day
3.67987
Adjusted CNA Staffing Hours per Resident per Day
3.28533
Adjusted LPN Staffing Hours per Resident per Day
0.99649
Adjusted RN Staffing Hours per Resident per Day
0.81248
Adjusted Total Nurse Staffing Hours per Resident per Day
5.05485
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-11-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-09-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-11-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
16.66700
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
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