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Fort Scott Manor - Fort Scott Nursing Home

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Federal Provider Number
175384
Provider Name
FORT SCOTT MANOR
Provider Address
736 HEYLMAN ST
FORT SCOTT, KS 66701
Provider Phone Number
(620) 223-3120
Provider SSA County
50
Provider County Name
Bourbon
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
38
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DJKIERL, INC.
Date First Approved to Provide Medicare and Medicaid services
1996-08-01
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
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.09474
Reported LPN Staffing Hours per Resident per Day
0.41711
Reported RN Staffing Hours per Resident per Day
0.72237
Reported Licensed Staffing Hours per Resident per Day
1.13947
Reported Total Nurse Staffing Hours per Resident per Day
4.23422
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02105
Expected CNA Staffing Hours per Resident per Day
2.41903
Expected LPN Staffing Hours per Resident per Day
0.65437
Expected RN Staffing Hours per Resident per Day
0.94012
Expected Total Nurse Staffing Hours per Resident per Day
4.01352
Adjusted CNA Staffing Hours per Resident per Day
3.13910
Adjusted LPN Staffing Hours per Resident per Day
0.52906
Adjusted RN Staffing Hours per Resident per Day
0.57413
Adjusted Total Nurse Staffing Hours per Resident per Day
4.25256
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
124
Cycle 1 Standard Survey Health Date
2014-12-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
124
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
76
Cycle 2 Standard Health Survey Date
2013-09-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
76
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
100
Cycle 3 Standard Health Survey Date
2012-06-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
100
Total Weighted Health Survey Score
104.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
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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