Coffey County Hospital Ltcu - Waverly Nursing Home
General Information
UPDATEFederal Provider Number
17E473
Provider Name
COFFEY COUNTY HOSPITAL LTCU
Provider Address
128 S PEARSON AVE
WAVERLY, KS 66871
WAVERLY, KS 66871
Provider Phone Number
7857332744
Provider SSA County
150
Provider County Name
Coffey
Ownership Type
Non profit - Other
Number of Certified Beds
42
Number of Residents in Certified Beds
27
Provider Type
Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1977-03-29
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
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
2.82222
Reported LPN Staffing Hours per Resident per Day
0.66111
Reported RN Staffing Hours per Resident per Day
0.87222
Reported Licensed Staffing Hours per Resident per Day
1.53333
Reported Total Nurse Staffing Hours per Resident per Day
4.35555
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.07607
Expected LPN Staffing Hours per Resident per Day
0.49923
Expected RN Staffing Hours per Resident per Day
0.62619
Expected Total Nurse Staffing Hours per Resident per Day
3.20149
Adjusted CNA Staffing Hours per Resident per Day
3.33557
Adjusted LPN Staffing Hours per Resident per Day
1.09914
Adjusted RN Staffing Hours per Resident per Day
1.04077
Adjusted Total Nurse Staffing Hours per Resident per Day
5.48395
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2015-03-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
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
28
Cycle 2 Standard Health Survey Date
2013-11-19
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-07-05
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
33.33300
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
Nursiong Homes Nearby
Life Care Center Of Burlington
601 Cross St |
BURLINGTON KS 66839 | 14.7 miles away
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