Holden Manor Care Center - Holden Nursing Home
General Information
UPDATEFederal Provider Number
265739
Provider Name
HOLDEN MANOR CARE CENTER
Provider Address
2005 SOUTH LEXINGTON
HOLDEN, MO 64040
HOLDEN, MO 64040
Provider Phone Number
(816) 732-4138
Provider SSA County
500
Provider County Name
Johnson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
52
Number of Residents in Certified Beds
34
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HOLDEN MANOR INC
Date First Approved to Provide Medicare and Medicaid services
2002-05-14
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
4
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
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
3.06176
Reported LPN Staffing Hours per Resident per Day
0.53088
Reported RN Staffing Hours per Resident per Day
0.87500
Reported Licensed Staffing Hours per Resident per Day
1.40588
Reported Total Nurse Staffing Hours per Resident per Day
4.46764
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09412
Expected CNA Staffing Hours per Resident per Day
2.18131
Expected LPN Staffing Hours per Resident per Day
0.57418
Expected RN Staffing Hours per Resident per Day
0.84541
Expected Total Nurse Staffing Hours per Resident per Day
3.60089
Adjusted CNA Staffing Hours per Resident per Day
3.44410
Adjusted LPN Staffing Hours per Resident per Day
0.76741
Adjusted RN Staffing Hours per Resident per Day
0.77336
Adjusted Total Nurse Staffing Hours per Resident per Day
5.00116
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-04-08
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2014-05-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
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
139
Cycle 3 Standard Health Survey Date
2013-06-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
139
Total Weighted Health Survey Score
53.16700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
5038
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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