Chapman Valley Manor - Chapman Nursing Home
General Information
UPDATEFederal Provider Number
175474
Provider Name
CHAPMAN VALLEY MANOR
Provider Address
PO BOX 219 1009 N MARSHALL
CHAPMAN, KS 67431
CHAPMAN, KS 67431
Provider Phone Number
(785) 922-6525
Provider SSA County
200
Provider County Name
Dickinson
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
45
Number of Residents in Certified Beds
45
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CHAPMAN ADULT CARE HOMES INC
Date First Approved to Provide Medicare and Medicaid services
2004-08-15
Continuing Care Retirement Community
Y
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
3.33222
Reported LPN Staffing Hours per Resident per Day
0.25444
Reported RN Staffing Hours per Resident per Day
0.63556
Reported Licensed Staffing Hours per Resident per Day
0.89000
Reported Total Nurse Staffing Hours per Resident per Day
4.22222
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.34461
Expected LPN Staffing Hours per Resident per Day
0.53481
Expected RN Staffing Hours per Resident per Day
0.70994
Expected Total Nurse Staffing Hours per Resident per Day
3.58937
Adjusted CNA Staffing Hours per Resident per Day
3.48725
Adjusted LPN Staffing Hours per Resident per Day
0.39488
Adjusted RN Staffing Hours per Resident per Day
0.66892
Adjusted Total Nurse Staffing Hours per Resident per Day
4.74160
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-05-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-04-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
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
8
Cycle 3 Standard Health Survey Date
2012-03-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
20.66700
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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