Oak Tree Villas-a Stonebridge Community - Jefferson City Nursing Home
General Information
UPDATEFederal Provider Number
265819
Provider Name
OAK TREE VILLAS-A STONEBRIDGE COMMUNITY
Provider Address
3108 WEST TRUMAN BOULEVARD
JEFFERSON CITY, MO 65109
JEFFERSON CITY, MO 65109
Provider Phone Number
(573) 893-3063
Provider SSA County
250
Provider County Name
Cole
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
42
Number of Residents in Certified Beds
28
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
ELDERCARE OF MID-MISSOURI VIII, INC.
Date First Approved to Provide Medicare and Medicaid services
2008-02-29
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
2
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
3.92143
Reported LPN Staffing Hours per Resident per Day
0.65536
Reported RN Staffing Hours per Resident per Day
1.06607
Reported Licensed Staffing Hours per Resident per Day
1.72143
Reported Total Nurse Staffing Hours per Resident per Day
5.64286
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07679
Expected CNA Staffing Hours per Resident per Day
2.40830
Expected LPN Staffing Hours per Resident per Day
0.57012
Expected RN Staffing Hours per Resident per Day
0.91464
Expected Total Nurse Staffing Hours per Resident per Day
3.89306
Adjusted CNA Staffing Hours per Resident per Day
3.99536
Adjusted LPN Staffing Hours per Resident per Day
0.95409
Adjusted RN Staffing Hours per Resident per Day
0.87091
Adjusted Total Nurse Staffing Hours per Resident per Day
5.84265
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-10-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-09-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-10-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
21.33300
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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