Coffeyville Regional Medical Center Snf - Coffeyville Nursing Home
General Information
UPDATEFederal Provider Number
175169
Provider Name
COFFEYVILLE REGIONAL MEDICAL CENTER SNF
Provider Address
1400 W 4TH PO BOX 850
COFFEYVILLE, KS 67337
COFFEYVILLE, KS 67337
Provider Phone Number
6202521100
Provider SSA County
620
Provider County Name
Montgomery
Ownership Type
Non profit - Corporation
Number of Certified Beds
20
Number of Residents in Certified Beds
13
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
COFFEYVILLE REGIONAL MEDICAL CENTER, INC.
Date First Approved to Provide Medicare and Medicaid services
1988-02-17
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
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
1.84615
Reported LPN Staffing Hours per Resident per Day
0.19615
Reported RN Staffing Hours per Resident per Day
2.48462
Reported Licensed Staffing Hours per Resident per Day
2.68077
Reported Total Nurse Staffing Hours per Resident per Day
4.52692
Reported Physical Therapist Staffing Hours per Resident Per Day
0.23077
Expected CNA Staffing Hours per Resident per Day
2.17337
Expected LPN Staffing Hours per Resident per Day
0.63748
Expected RN Staffing Hours per Resident per Day
1.60459
Expected Total Nurse Staffing Hours per Resident per Day
4.41544
Adjusted CNA Staffing Hours per Resident per Day
2.08428
Adjusted LPN Staffing Hours per Resident per Day
0.25539
Adjusted RN Staffing Hours per Resident per Day
1.15700
Adjusted Total Nurse Staffing Hours per Resident per Day
4.13267
Cycle 1 Total Number of Health Deficiencies
18
Cycle 1 Number of Standard Health Deficiencies
18
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
128
Cycle 1 Standard Survey Health Date
2014-06-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
128
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-03-11
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2011-12-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
90.00000
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
Medicalodges Coffeyville
720 W 1st St |
COFFEYVILLE KS 67337 | 0.7 mile away
Windsor Place Llc
2921 W 1st St |
COFFEYVILLE KS 67337 | 1.1 miles away
Montgomery Place Nursing Center
614 S 8th St |
INDEPENDENCE KS 67301 | 12.8 miles away
Medicalodges Independence
1000 Mulberry, Po Box 627 |
INDEPENDENCE KS 67301 | 14.8 miles away
Cherryvale Nursing And Rehabilitation Center
1001 W Main St Po Box 366 |
CHERRYVALE KS 67335 | 16.2 miles away
Caney Nursing Center
615 S High St |
CANEY KS 67333 | 16.4 miles away
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