Lutheran Senior Services At Breeze Park - Saint Charles Nursing Home
General Information
UPDATEFederal Provider Number
265767
Provider Name
LUTHERAN SENIOR SERVICES AT BREEZE PARK
Provider Address
600 BREEZE PARK DRIVE
SAINT CHARLES, MO 63304
SAINT CHARLES, MO 63304
Provider Phone Number
(636) 939-5223
Provider SSA County
910
Provider County Name
St. Charles
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
65
Number of Residents in Certified Beds
60
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LUTHERAN SENIOR SERVICES
Date First Approved to Provide Medicare and Medicaid services
2004-01-02
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.77167
Reported LPN Staffing Hours per Resident per Day
1.19583
Reported RN Staffing Hours per Resident per Day
0.70833
Reported Licensed Staffing Hours per Resident per Day
1.90417
Reported Total Nurse Staffing Hours per Resident per Day
4.67583
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06750
Expected CNA Staffing Hours per Resident per Day
2.54478
Expected LPN Staffing Hours per Resident per Day
0.57698
Expected RN Staffing Hours per Resident per Day
0.87474
Expected Total Nurse Staffing Hours per Resident per Day
3.99650
Adjusted CNA Staffing Hours per Resident per Day
2.67247
Adjusted LPN Staffing Hours per Resident per Day
1.72023
Adjusted RN Staffing Hours per Resident per Day
0.60505
Adjusted Total Nurse Staffing Hours per Resident per Day
4.71608
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-10-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-11-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
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
20
Cycle 3 Standard Health Survey Date
2013-01-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
10.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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