Excelsior Springs Medical Center - Excelsior Springs Nursing Home
General Information
UPDATEFederal Provider Number
26A494
Provider Name
EXCELSIOR SPRINGS MEDICAL CENTER
Provider Address
1700 RAINBOW BOULEVARD
EXCELSIOR SPRINGS, MO 64024
EXCELSIOR SPRINGS, MO 64024
Provider Phone Number
(816) 630-6081
Provider SSA County
230
Provider County Name
Clay
Provider Website
Provider Description
Ownership Type
Government - City
Number of Certified Beds
60
Number of Residents in Certified Beds
60
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
2007-02-01
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
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
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
1.61917
Reported LPN Staffing Hours per Resident per Day
0.70500
Reported RN Staffing Hours per Resident per Day
0.40167
Reported Licensed Staffing Hours per Resident per Day
1.10667
Reported Total Nurse Staffing Hours per Resident per Day
2.72584
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01750
Expected CNA Staffing Hours per Resident per Day
2.51003
Expected LPN Staffing Hours per Resident per Day
0.55254
Expected RN Staffing Hours per Resident per Day
0.72839
Expected Total Nurse Staffing Hours per Resident per Day
3.79096
Adjusted CNA Staffing Hours per Resident per Day
1.58283
Adjusted LPN Staffing Hours per Resident per Day
1.05901
Adjusted RN Staffing Hours per Resident per Day
0.41204
Adjusted Total Nurse Staffing Hours per Resident per Day
2.89836
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-11-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
17
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
112
Cycle 2 Standard Health Survey Date
2013-10-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
112
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-08-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
63.33300
Number of Facility Reported Incidents
1
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
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