Laverna Village Of St Joseph - Saint Joseph Nursing Home
General Information
UPDATEFederal Provider Number
265762
Provider Name
LAVERNA VILLAGE OF ST JOSEPH
Provider Address
1317 NORTH 36TH STREET
SAINT JOSEPH, MO 64506
SAINT JOSEPH, MO 64506
Provider Phone Number
(816) 676-1630
Provider SSA County
100
Provider County Name
Buchanan
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
77
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PHAV LLC
Date First Approved to Provide Medicare and Medicaid services
2003-04-22
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
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
2.98896
Reported LPN Staffing Hours per Resident per Day
0.87403
Reported RN Staffing Hours per Resident per Day
0.61234
Reported Licensed Staffing Hours per Resident per Day
1.48636
Reported Total Nurse Staffing Hours per Resident per Day
4.47533
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03052
Expected CNA Staffing Hours per Resident per Day
2.07118
Expected LPN Staffing Hours per Resident per Day
0.62166
Expected RN Staffing Hours per Resident per Day
0.96775
Expected Total Nurse Staffing Hours per Resident per Day
3.66059
Adjusted CNA Staffing Hours per Resident per Day
3.54098
Adjusted LPN Staffing Hours per Resident per Day
1.16695
Adjusted RN Staffing Hours per Resident per Day
0.47279
Adjusted Total Nurse Staffing Hours per Resident per Day
4.92806
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2015-02-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2014-02-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2013-01-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
70.00000
Number of Facility Reported Incidents
1
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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