Jackson Manor Nursing Home - Jackson Nursing Home
General Information
UPDATEFederal Provider Number
265438
Provider Name
JACKSON MANOR NURSING HOME
Provider Address
710 BROADRIDGE
JACKSON, MO 63755
JACKSON, MO 63755
Provider Phone Number
(573) 243-3101
Provider SSA County
150
Provider County Name
Cape Girardeau
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AGI - JACKSON MANOR, INC.
Date First Approved to Provide Medicare and Medicaid services
1990-10-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
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
2.01615
Reported LPN Staffing Hours per Resident per Day
0.67231
Reported RN Staffing Hours per Resident per Day
0.57000
Reported Licensed Staffing Hours per Resident per Day
1.24231
Reported Total Nurse Staffing Hours per Resident per Day
3.25846
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01615
Expected CNA Staffing Hours per Resident per Day
2.44196
Expected LPN Staffing Hours per Resident per Day
0.65276
Expected RN Staffing Hours per Resident per Day
1.01635
Expected Total Nurse Staffing Hours per Resident per Day
4.11107
Adjusted CNA Staffing Hours per Resident per Day
2.02584
Adjusted LPN Staffing Hours per Resident per Day
0.85486
Adjusted RN Staffing Hours per Resident per Day
0.41905
Adjusted Total Nurse Staffing Hours per Resident per Day
3.19491
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-02-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2014-03-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
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
20
Cycle 3 Standard Health Survey Date
2013-01-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
32.66700
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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