General Baptist Nursing Home - Campbell Nursing Home
General Information
UPDATEFederal Provider Number
265677
Provider Name
GENERAL BAPTIST NURSING HOME
Provider Address
17108 US HIGHWAY 62
CAMPBELL, MO 63933
CAMPBELL, MO 63933
Provider Phone Number
5732462155
Provider SSA County
340
Provider County Name
Dunklin
Ownership Type
Non profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
74
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GENERAL BAPTIST NURSING HOME, INC.
Date First Approved to Provide Medicare and Medicaid services
1997-08-07
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
2
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
2.50676
Reported LPN Staffing Hours per Resident per Day
0.42973
Reported RN Staffing Hours per Resident per Day
0.39527
Reported Licensed Staffing Hours per Resident per Day
0.82500
Reported Total Nurse Staffing Hours per Resident per Day
3.33176
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07703
Expected CNA Staffing Hours per Resident per Day
2.31102
Expected LPN Staffing Hours per Resident per Day
0.56015
Expected RN Staffing Hours per Resident per Day
0.85692
Expected Total Nurse Staffing Hours per Resident per Day
3.72809
Adjusted CNA Staffing Hours per Resident per Day
2.66152
Adjusted LPN Staffing Hours per Resident per Day
0.63675
Adjusted RN Staffing Hours per Resident per Day
0.34466
Adjusted Total Nurse Staffing Hours per Resident per Day
3.60238
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-07-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-08-22
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
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-07-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
34.66700
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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