Hidden Lake Care Center - Raytown Nursing Home
General Information
UPDATEFederal Provider Number
265510
Provider Name
HIDDEN LAKE CARE CENTER
Provider Address
11400 HIDDEN LAKE DRIVE, PO BOX 16567
RAYTOWN, MO 64133
RAYTOWN, MO 64133
Provider Phone Number
(816) 737-1010
Provider SSA County
470
Provider County Name
Jackson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
112
Number of Residents in Certified Beds
81
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HIDDEN LAKE MANAGEMENT LLC
Date First Approved to Provide Medicare and Medicaid services
1992-11-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
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
2.76543
Reported LPN Staffing Hours per Resident per Day
0.54321
Reported RN Staffing Hours per Resident per Day
0.38765
Reported Licensed Staffing Hours per Resident per Day
0.93086
Reported Total Nurse Staffing Hours per Resident per Day
3.69629
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07037
Expected CNA Staffing Hours per Resident per Day
2.28808
Expected LPN Staffing Hours per Resident per Day
0.56958
Expected RN Staffing Hours per Resident per Day
0.86955
Expected Total Nurse Staffing Hours per Resident per Day
3.72720
Adjusted CNA Staffing Hours per Resident per Day
2.96560
Adjusted LPN Staffing Hours per Resident per Day
0.79158
Adjusted RN Staffing Hours per Resident per Day
0.33311
Adjusted Total Nurse Staffing Hours per Resident per Day
3.99747
Cycle 1 Total Number of Health Deficiencies
19
Cycle 1 Number of Standard Health Deficiencies
19
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2015-02-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2014-02-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
80
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-11-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
77.33300
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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