Cherry Village - Great Bend Nursing Home
General Information
UPDATEFederal Provider Number
175522
Provider Name
CHERRY VILLAGE
Provider Address
1401 CHERRY LN
GREAT BEND, KS 67530
GREAT BEND, KS 67530
Provider Phone Number
(620) 792-2165
Provider SSA County
40
Provider County Name
Barton
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
44
Number of Residents in Certified Beds
32
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CHERRY VILLAGE BENEVOLENCE, INC.
Date First Approved to Provide Medicare and Medicaid services
2011-10-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
2.12500
Reported LPN Staffing Hours per Resident per Day
0.50938
Reported RN Staffing Hours per Resident per Day
0.94531
Reported Licensed Staffing Hours per Resident per Day
1.45469
Reported Total Nurse Staffing Hours per Resident per Day
3.57969
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07344
Expected CNA Staffing Hours per Resident per Day
2.32927
Expected LPN Staffing Hours per Resident per Day
0.59545
Expected RN Staffing Hours per Resident per Day
0.85776
Expected Total Nurse Staffing Hours per Resident per Day
3.78247
Adjusted CNA Staffing Hours per Resident per Day
2.23852
Adjusted LPN Staffing Hours per Resident per Day
0.71003
Adjusted RN Staffing Hours per Resident per Day
0.82347
Adjusted Total Nurse Staffing Hours per Resident per Day
3.81480
Cycle 1 Total Number of Health Deficiencies
22
Cycle 1 Number of Standard Health Deficiencies
21
Cycle 1 Number of Complaint Health Deficiencies
20
Cycle 1 Health Deficiency Score
140
Cycle 1 Standard Survey Health Date
2014-07-02
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
70
Cycle 1 Total Health Score
210
Cycle 2 Total Number of Health Deficiencies
33
Cycle 2 Number of Standard Health Deficiencies
26
Cycle 2 Number of Complaint Health Deficiencies
32
Cycle 2 Health Deficiency Score
351
Cycle 2 Standard Health Survey Date
2013-05-08
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
176
Cycle 2 Total Health Score
527
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2012-04-11
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
294.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
15
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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