Friendship Village Chesterfield - Chesterfield Nursing Home

General Information

UPDATE
Federal Provider Number
265121
Provider Name
FRIENDSHIP VILLAGE CHESTERFIELD
Provider Address
15201 OLIVE BOULEVARD
CHESTERFIELD, MO 63017
Provider Phone Number
6365321515
Provider SSA County
940
Provider County Name
St. Louis
Ownership Type
Non profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FRIENDSHIP VILLAGE OF WEST COUNTY
Date First Approved to Provide Medicare and Medicaid services
1975-10-15
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
3.81133
Reported LPN Staffing Hours per Resident per Day
1.00533
Reported RN Staffing Hours per Resident per Day
0.56733
Reported Licensed Staffing Hours per Resident per Day
1.57267
Reported Total Nurse Staffing Hours per Resident per Day
5.38399
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12067
Expected CNA Staffing Hours per Resident per Day
2.35884
Expected LPN Staffing Hours per Resident per Day
0.55365
Expected RN Staffing Hours per Resident per Day
0.87820
Expected Total Nurse Staffing Hours per Resident per Day
3.79069
Adjusted CNA Staffing Hours per Resident per Day
3.96459
Adjusted LPN Staffing Hours per Resident per Day
1.50714
Adjusted RN Staffing Hours per Resident per Day
0.48270
Adjusted Total Nurse Staffing Hours per Resident per Day
5.72516
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-06-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-04-04
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-06-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
7.33300
Number of Facility Reported Incidents
0
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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