Mount Joseph Senior Village Llc - Concordia Nursing Home
General Information
UPDATEFederal Provider Number
175420
Provider Name
MOUNT JOSEPH SENIOR VILLAGE LLC
Provider Address
1110 W 11TH
CONCORDIA, KS 66901
CONCORDIA, KS 66901
Provider Phone Number
(785) 243-1347
Provider SSA County
140
Provider County Name
Cloud
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
54
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MT JOSEPH SENIOR VILLAGE LLC
Date First Approved to Provide Medicare and Medicaid services
1997-09-08
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
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
2.05000
Reported LPN Staffing Hours per Resident per Day
0.86019
Reported RN Staffing Hours per Resident per Day
0.55370
Reported Licensed Staffing Hours per Resident per Day
1.41389
Reported Total Nurse Staffing Hours per Resident per Day
3.46389
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07130
Expected CNA Staffing Hours per Resident per Day
2.31189
Expected LPN Staffing Hours per Resident per Day
0.62598
Expected RN Staffing Hours per Resident per Day
0.97078
Expected Total Nurse Staffing Hours per Resident per Day
3.90865
Adjusted CNA Staffing Hours per Resident per Day
2.17575
Adjusted LPN Staffing Hours per Resident per Day
1.14054
Adjusted RN Staffing Hours per Resident per Day
0.42618
Adjusted Total Nurse Staffing Hours per Resident per Day
3.57223
Cycle 1 Total Number of Health Deficiencies
20
Cycle 1 Number of Standard Health Deficiencies
20
Cycle 1 Number of Complaint Health Deficiencies
19
Cycle 1 Health Deficiency Score
216
Cycle 1 Standard Survey Health Date
2014-08-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
216
Cycle 2 Total Number of Health Deficiencies
21
Cycle 2 Number of Standard Health Deficiencies
19
Cycle 2 Number of Complaint Health Deficiencies
21
Cycle 2 Health Deficiency Score
216
Cycle 2 Standard Health Survey Date
2013-08-26
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
108
Cycle 2 Total Health Score
324
Cycle 3 Total Number of Health Deficiencies
20
Cycle 3 Number of Standard Health Deficiencies
20
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
112
Cycle 3 Standard Health Survey Date
2012-07-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
112
Total Weighted Health Survey Score
234.66700
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
12
Number of Fines
1
Total Amount of Fines in Dollars
8400
Number of Payment Denials
2
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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