Indian Creek Healthcare Center - Overland Park Nursing Home
General Information
UPDATEFederal Provider Number
175176
Provider Name
INDIAN CREEK HEALTHCARE CENTER
Provider Address
6515 W 103RD ST
OVERLAND PARK, KS 66212
OVERLAND PARK, KS 66212
Provider Phone Number
(913) 642-5545
Provider SSA County
450
Provider County Name
Johnson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
95
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
INDIAN CREEK OPERATING COMPANY LLC
Date First Approved to Provide Medicare and Medicaid services
1988-09-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
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
1.98579
Reported LPN Staffing Hours per Resident per Day
0.98368
Reported RN Staffing Hours per Resident per Day
0.51263
Reported Licensed Staffing Hours per Resident per Day
1.49632
Reported Total Nurse Staffing Hours per Resident per Day
3.48210
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03158
Expected CNA Staffing Hours per Resident per Day
2.29387
Expected LPN Staffing Hours per Resident per Day
0.63982
Expected RN Staffing Hours per Resident per Day
1.13447
Expected Total Nurse Staffing Hours per Resident per Day
4.06815
Adjusted CNA Staffing Hours per Resident per Day
2.12416
Adjusted LPN Staffing Hours per Resident per Day
1.27607
Adjusted RN Staffing Hours per Resident per Day
0.33763
Adjusted Total Nurse Staffing Hours per Resident per Day
3.45021
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
96
Cycle 1 Standard Survey Health Date
2014-03-07
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
48
Cycle 1 Total Health Score
144
Cycle 2 Total Number of Health Deficiencies
16
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
16
Cycle 2 Health Deficiency Score
100
Cycle 2 Standard Health Survey Date
2012-11-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
100
Cycle 3 Total Number of Health Deficiencies
19
Cycle 3 Number of Standard Health Deficiencies
19
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
116
Cycle 3 Standard Health Survey Date
2011-08-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
116
Total Weighted Health Survey Score
124.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
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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