Jefferson City Manor Care Center - Jefferson City Nursing Home
General Information
UPDATEFederal Provider Number
265285
Provider Name
JEFFERSON CITY MANOR CARE CENTER
Provider Address
1720 VIETH DR
JEFFERSON CITY, MO 65109
JEFFERSON CITY, MO 65109
Provider Phone Number
(573) 635-6193
Provider SSA County
250
Provider County Name
Cole
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
102
Number of Residents in Certified Beds
74
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
JEFFERSON CITY MANOR INC
Date First Approved to Provide Medicare and Medicaid services
1985-08-22
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
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
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
2.65946
Reported LPN Staffing Hours per Resident per Day
0.70811
Reported RN Staffing Hours per Resident per Day
0.58919
Reported Licensed Staffing Hours per Resident per Day
1.29730
Reported Total Nurse Staffing Hours per Resident per Day
3.95676
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02973
Expected CNA Staffing Hours per Resident per Day
2.25162
Expected LPN Staffing Hours per Resident per Day
0.59103
Expected RN Staffing Hours per Resident per Day
0.88250
Expected Total Nurse Staffing Hours per Resident per Day
3.72515
Adjusted CNA Staffing Hours per Resident per Day
2.89814
Adjusted LPN Staffing Hours per Resident per Day
0.99442
Adjusted RN Staffing Hours per Resident per Day
0.49886
Adjusted Total Nurse Staffing Hours per Resident per Day
4.28152
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
16
Cycle 1 Standard Survey Health Date
2015-01-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-12-05
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-12-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
18.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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