Delhaven Manor - Saint Louis Nursing Home
General Information
UPDATEFederal Provider Number
265392
Provider Name
DELHAVEN MANOR
Provider Address
5460 DELMAR BLVD
SAINT LOUIS, MO 63112
SAINT LOUIS, MO 63112
Provider Phone Number
3143612902
Provider SSA County
950
Provider County Name
St. Louis City
Ownership Type
For profit - Corporation
Number of Certified Beds
156
Number of Residents in Certified Beds
62
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DELHAVEN MANOR NO 2 INC
Date First Approved to Provide Medicare and Medicaid services
1989-08-30
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.13306
Reported LPN Staffing Hours per Resident per Day
0.79839
Reported RN Staffing Hours per Resident per Day
0.43145
Reported Licensed Staffing Hours per Resident per Day
1.22984
Reported Total Nurse Staffing Hours per Resident per Day
3.36290
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04597
Expected CNA Staffing Hours per Resident per Day
1.99987
Expected LPN Staffing Hours per Resident per Day
0.57658
Expected RN Staffing Hours per Resident per Day
0.77087
Expected Total Nurse Staffing Hours per Resident per Day
3.34732
Adjusted CNA Staffing Hours per Resident per Day
2.61711
Adjusted LPN Staffing Hours per Resident per Day
1.14929
Adjusted RN Staffing Hours per Resident per Day
0.41820
Adjusted Total Nurse Staffing Hours per Resident per Day
4.04966
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-09-18
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
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-08-15
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
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-10-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
34.00000
Number of Facility Reported Incidents
1
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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