Golden Livingcenter-bloomfield - Bloomfield Nursing Home
General Information
UPDATEFederal Provider Number
265451
Provider Name
GOLDEN LIVINGCENTER-BLOOMFIELD
Provider Address
606 WEST MISSOURI STREET
BLOOMFIELD, MO 63825
BLOOMFIELD, MO 63825
Provider Phone Number
(573) 568-2137
Provider SSA County
985
Provider County Name
Stoddard
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
35
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GGNSC BLOOMFIELD LLC
Date First Approved to Provide Medicare and Medicaid services
1991-06-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.66429
Reported LPN Staffing Hours per Resident per Day
0.79857
Reported RN Staffing Hours per Resident per Day
1.08571
Reported Licensed Staffing Hours per Resident per Day
1.88429
Reported Total Nurse Staffing Hours per Resident per Day
3.54857
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10143
Expected CNA Staffing Hours per Resident per Day
2.49267
Expected LPN Staffing Hours per Resident per Day
0.62045
Expected RN Staffing Hours per Resident per Day
0.91611
Expected Total Nurse Staffing Hours per Resident per Day
4.02924
Adjusted CNA Staffing Hours per Resident per Day
1.63827
Adjusted LPN Staffing Hours per Resident per Day
1.06827
Adjusted RN Staffing Hours per Resident per Day
0.88553
Adjusted Total Nurse Staffing Hours per Resident per Day
3.55004
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2015-01-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
107
Cycle 2 Standard Health Survey Date
2013-12-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
107
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
20
Cycle 3 Standard Health Survey Date
2012-12-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
73.00000
Number of Facility Reported Incidents
1
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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