Medicalodges Douglass - Douglass Nursing Home

General Information

UPDATE
Federal Provider Number
175292
Provider Name
MEDICALODGES DOUGLASS
Provider Address
619 S HIGHWAY 77
DOUGLASS, KS 67039
Provider Phone Number
3167472157
Provider SSA County
70
Provider County Name
Butler
Ownership Type
For profit - Corporation
Number of Certified Beds
42
Number of Residents in Certified Beds
33
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MEDICALODGES INC
Date First Approved to Provide Medicare and Medicaid services
1994-06-01
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.36061
Reported LPN Staffing Hours per Resident per Day
0.47273
Reported RN Staffing Hours per Resident per Day
1.03636
Reported Licensed Staffing Hours per Resident per Day
1.50909
Reported Total Nurse Staffing Hours per Resident per Day
3.86970
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02879
Expected CNA Staffing Hours per Resident per Day
2.20392
Expected LPN Staffing Hours per Resident per Day
0.57351
Expected RN Staffing Hours per Resident per Day
0.78056
Expected Total Nurse Staffing Hours per Resident per Day
3.55799
Adjusted CNA Staffing Hours per Resident per Day
2.62815
Adjusted LPN Staffing Hours per Resident per Day
0.68415
Adjusted RN Staffing Hours per Resident per Day
0.99207
Adjusted Total Nurse Staffing Hours per Resident per Day
4.38405
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
2014-08-06
Cycle 1 Number of Health Revisits
1
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
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-04-25
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
14
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2012-01-25
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
53.33300
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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