Kansas Soldiers Home - Fort Dodge Nursing Home
General Information
UPDATEFederal Provider Number
175513
Provider Name
KANSAS SOLDIERS HOME
Provider Address
714 SHERIDAN UNIT 98
FORT DODGE, KS 67843
FORT DODGE, KS 67843
Provider Phone Number
6202272121
Provider SSA County
280
Provider County Name
Ford
Ownership Type
Government - State
Number of Certified Beds
72
Number of Residents in Certified Beds
53
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
STATE OF KANSAS ACCOUNTING SERVICES
Date First Approved to Provide Medicare and Medicaid services
2009-09-17
Continuing Care Retirement Community
Y
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
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
3.26698
Reported LPN Staffing Hours per Resident per Day
0.50189
Reported RN Staffing Hours per Resident per Day
0.94906
Reported Licensed Staffing Hours per Resident per Day
1.45094
Reported Total Nurse Staffing Hours per Resident per Day
4.71793
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01038
Expected CNA Staffing Hours per Resident per Day
2.31665
Expected LPN Staffing Hours per Resident per Day
0.64423
Expected RN Staffing Hours per Resident per Day
0.98193
Expected Total Nurse Staffing Hours per Resident per Day
3.94282
Adjusted CNA Staffing Hours per Resident per Day
3.46024
Adjusted LPN Staffing Hours per Resident per Day
0.64661
Adjusted RN Staffing Hours per Resident per Day
0.72219
Adjusted Total Nurse Staffing Hours per Resident per Day
4.82333
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
108
Cycle 1 Standard Survey Health Date
2014-10-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
108
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
9
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-07-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
2012-03-26
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
82.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
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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