Medicalodges Coffeyville - Coffeyville Nursing Home
General Information
UPDATEFederal Provider Number
175237
Provider Name
MEDICALODGES COFFEYVILLE
Provider Address
720 W 1ST ST
COFFEYVILLE, KS 67337
COFFEYVILLE, KS 67337
Provider Phone Number
(620) 251-3705
Provider SSA County
620
Provider County Name
Montgomery
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
40
Number of Residents in Certified Beds
24
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MEDICALODGES INC
Date First Approved to Provide Medicare and Medicaid services
1993-02-05
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.39375
Reported LPN Staffing Hours per Resident per Day
0.58333
Reported RN Staffing Hours per Resident per Day
1.78125
Reported Licensed Staffing Hours per Resident per Day
2.36458
Reported Total Nurse Staffing Hours per Resident per Day
4.75833
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01458
Expected CNA Staffing Hours per Resident per Day
2.21525
Expected LPN Staffing Hours per Resident per Day
0.62639
Expected RN Staffing Hours per Resident per Day
0.94630
Expected Total Nurse Staffing Hours per Resident per Day
3.78794
Adjusted CNA Staffing Hours per Resident per Day
2.65141
Adjusted LPN Staffing Hours per Resident per Day
0.77294
Adjusted RN Staffing Hours per Resident per Day
1.40648
Adjusted Total Nurse Staffing Hours per Resident per Day
5.06353
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-03-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2012-12-03
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
28
Cycle 3 Standard Health Survey Date
2011-09-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
36.00000
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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