Life Care Center Of Andover - Andover Nursing Home
General Information
UPDATEFederal Provider Number
175157
Provider Name
LIFE CARE CENTER OF ANDOVER
Provider Address
621 W 21ST PO BOX 100
ANDOVER, KS 67002
ANDOVER, KS 67002
Provider Phone Number
(316) 733-1349
Provider SSA County
70
Provider County Name
Butler
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
154
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ANDOVER MEDIAL INVESTORS LLC
Date First Approved to Provide Medicare and Medicaid services
1986-10-31
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
2
QM Rating Footnote
Staffing Rating
3
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
2.15523
Reported LPN Staffing Hours per Resident per Day
0.79302
Reported RN Staffing Hours per Resident per Day
0.75640
Reported Licensed Staffing Hours per Resident per Day
1.54942
Reported Total Nurse Staffing Hours per Resident per Day
3.70465
Reported Physical Therapist Staffing Hours per Resident Per Day
0.24884
Expected CNA Staffing Hours per Resident per Day
2.60841
Expected LPN Staffing Hours per Resident per Day
0.70361
Expected RN Staffing Hours per Resident per Day
1.18769
Expected Total Nurse Staffing Hours per Resident per Day
4.49971
Adjusted CNA Staffing Hours per Resident per Day
2.02740
Adjusted LPN Staffing Hours per Resident per Day
0.93547
Adjusted RN Staffing Hours per Resident per Day
0.47587
Adjusted Total Nurse Staffing Hours per Resident per Day
3.31868
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
12
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2015-04-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-12-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-09-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
62.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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