Maywood Terrace Living Center - Independence Nursing Home
General Information
UPDATEFederal Provider Number
265404
Provider Name
MAYWOOD TERRACE LIVING CENTER
Provider Address
10300 EAST TRUMAN RD
INDEPENDENCE, MO 64052
INDEPENDENCE, MO 64052
Provider Phone Number
(816) 836-1250
Provider SSA County
470
Provider County Name
Jackson
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
89
Number of Residents in Certified Beds
45
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
INDEPENDENCE 1 INC
Date First Approved to Provide Medicare and Medicaid services
1989-11-20
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
2
Health Inspection Rating Footnote
QM Rating
5
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
2.16111
Reported LPN Staffing Hours per Resident per Day
0.88889
Reported RN Staffing Hours per Resident per Day
0.60333
Reported Licensed Staffing Hours per Resident per Day
1.49222
Reported Total Nurse Staffing Hours per Resident per Day
3.65333
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05111
Expected CNA Staffing Hours per Resident per Day
2.42247
Expected LPN Staffing Hours per Resident per Day
0.66242
Expected RN Staffing Hours per Resident per Day
0.88538
Expected Total Nurse Staffing Hours per Resident per Day
3.97028
Adjusted CNA Staffing Hours per Resident per Day
2.18897
Adjusted LPN Staffing Hours per Resident per Day
1.11376
Adjusted RN Staffing Hours per Resident per Day
0.50917
Adjusted Total Nurse Staffing Hours per Resident per Day
3.70911
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2015-03-09
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2014-02-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2013-04-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
49.33300
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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