Moundridge Manor - Moundridge Nursing Home
General Information
UPDATEFederal Provider Number
17E458
Provider Name
MOUNDRIDGE MANOR
Provider Address
710 N CHRISTIAN AVE
MOUNDRIDGE, KS 67107
MOUNDRIDGE, KS 67107
Provider Phone Number
(620) 345-6364
Provider SSA County
560
Provider County Name
Mcpherson
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
77
Number of Residents in Certified Beds
75
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1976-07-26
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
5
Health Inspection Rating Footnote
QM Rating
4
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
3.02933
Reported LPN Staffing Hours per Resident per Day
0.26600
Reported RN Staffing Hours per Resident per Day
0.71067
Reported Licensed Staffing Hours per Resident per Day
0.97667
Reported Total Nurse Staffing Hours per Resident per Day
4.00600
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00200
Expected CNA Staffing Hours per Resident per Day
2.16340
Expected LPN Staffing Hours per Resident per Day
0.54971
Expected RN Staffing Hours per Resident per Day
0.65548
Expected Total Nurse Staffing Hours per Resident per Day
3.36859
Adjusted CNA Staffing Hours per Resident per Day
3.43583
Adjusted LPN Staffing Hours per Resident per Day
0.40163
Adjusted RN Staffing Hours per Resident per Day
0.81011
Adjusted Total Nurse Staffing Hours per Resident per Day
4.79363
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-09-11
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-07-23
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-04-26
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
1.33300
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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