Life Care Center Of Sullivan - Sullivan Nursing Home
General Information
UPDATEFederal Provider Number
265340
Provider Name
LIFE CARE CENTER OF SULLIVAN
Provider Address
875 DUNSFORD DRIVE
SULLIVAN, MO 63080
SULLIVAN, MO 63080
Provider Phone Number
(573) 468-3128
Provider SSA County
350
Provider County Name
Franklin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
64
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SULLIVAN OPERATIONS, LLC
Date First Approved to Provide Medicare and Medicaid services
1989-01-01
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
4
Health Inspection Rating Footnote
QM Rating
1
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
2.13984
Reported LPN Staffing Hours per Resident per Day
1.13359
Reported RN Staffing Hours per Resident per Day
0.56250
Reported Licensed Staffing Hours per Resident per Day
1.69609
Reported Total Nurse Staffing Hours per Resident per Day
3.83593
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17656
Expected CNA Staffing Hours per Resident per Day
2.31567
Expected LPN Staffing Hours per Resident per Day
0.61798
Expected RN Staffing Hours per Resident per Day
1.08939
Expected Total Nurse Staffing Hours per Resident per Day
4.02303
Adjusted CNA Staffing Hours per Resident per Day
2.26739
Adjusted LPN Staffing Hours per Resident per Day
1.52251
Adjusted RN Staffing Hours per Resident per Day
0.38581
Adjusted Total Nurse Staffing Hours per Resident per Day
3.84343
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-09-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-10-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
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
32
Cycle 3 Standard Health Survey Date
2012-09-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
15.33300
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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