Independence Care Center Of Perry County - Perryville Nursing Home
General Information
UPDATEFederal Provider Number
265829
Provider Name
INDEPENDENCE CARE CENTER OF PERRY COUNTY
Provider Address
800 SOUTH KINGSHIGHWAY
PERRYVILLE, MO 63775
PERRYVILLE, MO 63775
Provider Phone Number
(573) 547-6546
Provider SSA County
780
Provider County Name
Perry
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
123
Number of Residents in Certified Beds
111
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
INDEPENDENCE HEALTH SYSTEM INC
Date First Approved to Provide Medicare and Medicaid services
2009-04-24
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
2.48378
Reported LPN Staffing Hours per Resident per Day
0.55045
Reported RN Staffing Hours per Resident per Day
0.36306
Reported Licensed Staffing Hours per Resident per Day
0.91351
Reported Total Nurse Staffing Hours per Resident per Day
3.39729
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04234
Expected CNA Staffing Hours per Resident per Day
2.51141
Expected LPN Staffing Hours per Resident per Day
0.58975
Expected RN Staffing Hours per Resident per Day
0.82604
Expected Total Nurse Staffing Hours per Resident per Day
3.92720
Adjusted CNA Staffing Hours per Resident per Day
2.42671
Adjusted LPN Staffing Hours per Resident per Day
0.77469
Adjusted RN Staffing Hours per Resident per Day
0.32841
Adjusted Total Nurse Staffing Hours per Resident per Day
3.48700
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-06-06
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
6
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-05-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-06-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
50.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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Nursiong Homes Nearby
Estates Of Perryville, Llc, The
430 North West Street |
PERRYVILLE MO 63775 | 0.8 mile away