Clark's Mountain Nursing Center - Piedmont Nursing Home
General Information
UPDATEFederal Provider Number
265416
Provider Name
CLARK'S MOUNTAIN NURSING CENTER
Provider Address
2100 BARNES
PIEDMONT, MO 63957
PIEDMONT, MO 63957
Provider Phone Number
(573) 223-4297
Provider SSA County
993
Provider County Name
Wayne
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
91
Number of Residents in Certified Beds
64
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AMERICARE AT CLARK'S MOUNTAIN NURSING CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
1990-02-09
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
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
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
2.75469
Reported LPN Staffing Hours per Resident per Day
0.65469
Reported RN Staffing Hours per Resident per Day
0.78125
Reported Licensed Staffing Hours per Resident per Day
1.43594
Reported Total Nurse Staffing Hours per Resident per Day
4.19063
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02109
Expected CNA Staffing Hours per Resident per Day
2.42929
Expected LPN Staffing Hours per Resident per Day
0.61264
Expected RN Staffing Hours per Resident per Day
0.96870
Expected Total Nurse Staffing Hours per Resident per Day
4.01062
Adjusted CNA Staffing Hours per Resident per Day
2.78237
Adjusted LPN Staffing Hours per Resident per Day
0.88697
Adjusted RN Staffing Hours per Resident per Day
0.60261
Adjusted Total Nurse Staffing Hours per Resident per Day
4.21182
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-10-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-12-05
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
4
Cycle 3 Standard Health Survey Date
2012-11-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
26.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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