Diversicare Of Haysville - Haysville Nursing Home
General Information
UPDATEFederal Provider Number
175133
Provider Name
DIVERSICARE OF HAYSVILLE
Provider Address
215 N LAMAR AVE
HAYSVILLE, KS 67060
HAYSVILLE, KS 67060
Provider Phone Number
3165243211
Provider SSA County
860
Provider County Name
Sedgwick
Ownership Type
For profit - Corporation
Number of Certified Beds
119
Number of Residents in Certified Beds
102
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DIVERSICARE OF HAYSVILLE LLC
Date First Approved to Provide Medicare and Medicaid services
1984-07-12
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
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
1.92353
Reported LPN Staffing Hours per Resident per Day
0.79510
Reported RN Staffing Hours per Resident per Day
0.52892
Reported Licensed Staffing Hours per Resident per Day
1.32402
Reported Total Nurse Staffing Hours per Resident per Day
3.24755
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04559
Expected CNA Staffing Hours per Resident per Day
2.33844
Expected LPN Staffing Hours per Resident per Day
0.60582
Expected RN Staffing Hours per Resident per Day
0.88520
Expected Total Nurse Staffing Hours per Resident per Day
3.82947
Adjusted CNA Staffing Hours per Resident per Day
2.01834
Adjusted LPN Staffing Hours per Resident per Day
1.08932
Adjusted RN Staffing Hours per Resident per Day
0.44646
Adjusted Total Nurse Staffing Hours per Resident per Day
3.41837
Cycle 1 Total Number of Health Deficiencies
21
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
8
Cycle 1 Health Deficiency Score
188
Cycle 1 Standard Survey Health Date
2014-03-06
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
188
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
10
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2012-11-14
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
15
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
124
Cycle 3 Standard Health Survey Date
2011-07-21
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
62
Cycle 3 Total Health Score
186
Total Weighted Health Survey Score
147.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
14
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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