Hillside Village Of Desoto - De Soto Nursing Home
General Information
UPDATEFederal Provider Number
175472
Provider Name
HILLSIDE VILLAGE OF DESOTO
Provider Address
33600 WEST 85TH ST
DE SOTO, KS 66018
DE SOTO, KS 66018
Provider Phone Number
(913) 583-1266
Provider SSA County
450
Provider County Name
Johnson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
95
Number of Residents in Certified Beds
44
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HILLSIDE VILLAGE LLC
Date First Approved to Provide Medicare and Medicaid services
2003-11-28
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
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
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
3.49545
Reported LPN Staffing Hours per Resident per Day
0.59659
Reported RN Staffing Hours per Resident per Day
0.56136
Reported Licensed Staffing Hours per Resident per Day
1.15795
Reported Total Nurse Staffing Hours per Resident per Day
4.65340
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12955
Expected CNA Staffing Hours per Resident per Day
2.41628
Expected LPN Staffing Hours per Resident per Day
0.57998
Expected RN Staffing Hours per Resident per Day
0.91623
Expected Total Nurse Staffing Hours per Resident per Day
3.91250
Adjusted CNA Staffing Hours per Resident per Day
3.54958
Adjusted LPN Staffing Hours per Resident per Day
0.85376
Adjusted RN Staffing Hours per Resident per Day
0.45780
Adjusted Total Nurse Staffing Hours per Resident per Day
4.79422
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
8
Cycle 1 Standard Survey Health Date
2015-04-15
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
24
Cycle 2 Standard Health Survey Date
2014-01-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
22
Cycle 3 Number of Standard Health Deficiencies
22
Cycle 3 Number of Complaint Health Deficiencies
18
Cycle 3 Health Deficiency Score
188
Cycle 3 Standard Health Survey Date
2012-09-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
188
Total Weighted Health Survey Score
43.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
4
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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