Forsyth Care Center - Forsyth Nursing Home
General Information
UPDATEFederal Provider Number
265605
Provider Name
FORSYTH CARE CENTER
Provider Address
477 COY BLVD, PO BOX 640
FORSYTH, MO 65653
FORSYTH, MO 65653
Provider Phone Number
(417) 546-6337
Provider SSA County
988
Provider County Name
Taney
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
79
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FORSYTH MANOR INC
Date First Approved to Provide Medicare and Medicaid services
1995-05-01
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
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.18291
Reported LPN Staffing Hours per Resident per Day
0.79051
Reported RN Staffing Hours per Resident per Day
0.46772
Reported Licensed Staffing Hours per Resident per Day
1.25823
Reported Total Nurse Staffing Hours per Resident per Day
3.44114
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08544
Expected CNA Staffing Hours per Resident per Day
2.19009
Expected LPN Staffing Hours per Resident per Day
0.62612
Expected RN Staffing Hours per Resident per Day
0.98415
Expected Total Nurse Staffing Hours per Resident per Day
3.80036
Adjusted CNA Staffing Hours per Resident per Day
2.44566
Adjusted LPN Staffing Hours per Resident per Day
1.04793
Adjusted RN Staffing Hours per Resident per Day
0.35511
Adjusted Total Nurse Staffing Hours per Resident per Day
3.64989
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2015-03-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2014-05-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2013-05-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
30.66700
Number of Facility Reported Incidents
0
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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