Hodgeman County Health Center Ltcu - Jetmore Nursing Home
General Information
UPDATEFederal Provider Number
17E627
Provider Name
HODGEMAN COUNTY HEALTH CENTER LTCU
Provider Address
809 BRAMLEY PO BOX 367
JETMORE, KS 67854
JETMORE, KS 67854
Provider Phone Number
6203578361
Provider SSA County
410
Provider County Name
Hodgeman
Ownership Type
Government - County
Number of Certified Beds
25
Number of Residents in Certified Beds
22
Provider Type
Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2005-02-25
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
5
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
3.78636
Reported LPN Staffing Hours per Resident per Day
0.27500
Reported RN Staffing Hours per Resident per Day
1.43182
Reported Licensed Staffing Hours per Resident per Day
1.70682
Reported Total Nurse Staffing Hours per Resident per Day
5.49318
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07045
Expected CNA Staffing Hours per Resident per Day
2.23429
Expected LPN Staffing Hours per Resident per Day
0.60065
Expected RN Staffing Hours per Resident per Day
0.83413
Expected Total Nurse Staffing Hours per Resident per Day
3.66907
Adjusted CNA Staffing Hours per Resident per Day
4.15819
Adjusted LPN Staffing Hours per Resident per Day
0.38000
Adjusted RN Staffing Hours per Resident per Day
1.28260
Adjusted Total Nurse Staffing Hours per Resident per Day
6.03490
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-08-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-05-21
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-02-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
40.00000
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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